title: Hospitalisation of and mortality from bleeding peptic ulcer in Sweden: a nationwide time-trend analysis.
abstract: BACKGROUND
  Time-trend analyses of incidence and mortality in bleeding peptic ulcer show divergent results.
  
  
  OBJECTIVE
  To conduct a detailed national analysis of hospitalisation of and mortality from bleeding peptic ulcer in Sweden.
  
  
  METHODS
  Data from all hospitalisations at departments with primary responsibility for patients with bleeding ulcer in Sweden, with main diagnosis or co-diagnosis of bleeding ulcer from 1987 to 2005 were retrieved from the Hospital Discharge Register. A validation study was performed due to an uncertainty in diagnostic setting after the introduction of ICD-10 in 1997. Annual hospitalisation rates per 100 000 inhabitants in relation to gender, age and ulcer location were calculated as well as age-standardised 30-day mortality rates.
  
  
  RESULTS
  Hospitalisations for bleeding ulcer decreased from 63.9 to 35.3 per 100 000 inhabitants per year during the study period. The decrease was greater among men (men: from 80.4 to 40.9; women: from 47.7 to 29.7) and in younger age groups. Bleeding gastric ulcer decreased in both genders, and bleeding duodenal ulcer decreased most among men, but was stable in a subgroup of elderly women. Median age increased from 70 to 76 years. Standardised 30-day mortality increased from 5.3% to 6.2%. The increased mortality was found in those aged more than 65 years and with duodenal ulcer disease, whereas mortality remained unchanged in those with bleeding gastric ulcer.
  
  
  CONCLUSIONS
  Hospitalisation rates for bleeding peptic ulcer have markedly decreased in Sweden in all age groups. The 30-day mortality is low compared with other nationwide studies in the western world, but has increased among patients with duodenal ulcer disease.
authors.affiliation: Department of Surgery, Lund University Hospital, Lund University, Sweden.
authors.forename: K
authors.initials: K
authors.lastname: Ahsberg
authors.forename: W
authors.initials: W
authors.lastname: Ye
authors.forename: Y
authors.initials: Y
authors.lastname: Lu
authors.forename: Z
authors.initials: Z
authors.lastname: Zheng
authors.forename: C
authors.initials: C
authors.lastname: Staël von Holstein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016481:Helicobacter Infections / Q000150:complications*; D016480:Helicobacter pylori / Q000302:isolation & purification; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000453:epidemiology* / Q000401:mortality; D010438:Peptic Ulcer Hemorrhage / Q000401:mortality / Q000628:therapy*; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors