title: Use of non-steroidal anti-inflammatory drugs and proton pump inhibitors in correlation with incidence, recurrence and death of peptic ulcer bleeding: an ecological study.
abstract: BACKGROUND
  Non-steroidal anti-inflammatory drugs (NSAIDs) and proton pump inhibitors (PPIs) are regarded as two types of drugs that respectively increase and decrease the risk of peptic ulcer bleeding. However, their relation to occurrence, recurrence and death of bleeding in the population level is not clear.
  
  
  OBJECTIVE
  To clarify recent calendar-time correlations between sales of NSAIDs and PPIs and the occurrence of peptic ulcer bleeding, re-bleeding and death.
  
  
  METHODS
  Ecological study.
  
  
  RESULTS
  The time trend of peptic ulcer bleeding did not correlate with PPI sales but did correlate with NSAIDs in mem (R(male)=0.6571, P(male)=0.05). Sales of PPIs (inverse) and NSAIDs correlated with re-bleeding in women (R(male)=-0.8754, P(male)=0.002 and R(female)=0.7161, P(female)=0.03, respectively), but not in men. An inverse correlation between PPI sales and 30-day death after bleeding was found (R(male)=-0.9392, P(male)=0.0002 and R(female)=-0.8561, P(female)=0.003), and NSAID sales were found to correlate with increased death after bleeding ((R(male)=0.7278, P(male)=0.03, R(female)=0.7858, P(female)=0.01).
  
  
  CONCLUSIONS
  The sales of NSAIDs and PPIs correlate with recurrence of peptic ulcer bleeding in women and death after peptic ulcer bleeding in both genders in the population level.
authors.affiliation: Upper Gastrointestinal Research, Department of Molecular Medicine and Surgery,  Karolinska Institutet, Stockholm,  Sweden.
authors.forename: Yunxia
authors.initials: Y
authors.lastname: Lu
authors.forename: Emma
authors.initials: E
authors.lastname: Sverdén
authors.forename: Rickard
authors.initials: R
authors.lastname: Ljung
authors.forename: Claes
authors.initials: C
authors.lastname: Söderlund
authors.forename: Jesper
authors.initials: J
authors.lastname: Lagergren