Bleeding peptic ulcer - time trends in incidence, treatment and mortality in Sweden.
BACKGROUND
The incidence of peptic ulcer disease was expected to decrease following the introduction of acid inhibitors and Helicobacter pylori eradication.


OBJECTIVE
To analyse possible changes in the incidence of bleeding peptic ulcer, treatment and mortality over time.


METHODS
Residents of Malmö hospitalized for bleeding gastric or duodenal ulcer disease during 1987-2004 were identified in hospital databases (n = 1610). The material was divided into 6-year periods to identify changes over time. All patients who had been submitted to emergency surgery (n = 137) were reviewed.


RESULTS
The incidence rate for bleeding gastric or duodenal ulcers decreased by one half in males and by one-third in females and emergency operations decreased significantly (9.2%, 7.5% and 5.7% during the three time periods, respectively (P < 0.05). The post-operative mortality tended to decrease (9.7, 2.4 and 3.7%, respectively) and the 30-day mortality rates in the whole material were 1.2%, 3.6% and 3.4% during the different time periods.


CONCLUSIONS
The incidence of bleeding gastric and duodenal ulcer disease has decreased markedly. Operative treatment has been replaced by endoscopic treatment. The bleeding ulcer-related mortality was less than 4% and has not changed over time.
Sadic
J
J
Department of Surgery, Malmö University Hospital, Lund University, Malmö, Sweden.
Borgström
A
A
Manjer
J
J
Toth
E
E
Lindell
G
G
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D010438:Peptic Ulcer Hemorrhage / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D012307:Risk Factors; D017678:Sex Distribution; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
D000897:Anti-Ulcer Agents