title: Increased short- and long-term mortality in 8146 hospitalised peptic ulcer patients.
abstract: Incidence and complications of peptic ulcer disease (PUD) have declined, but mortality from peptic ulcer bleeding has remained unchanged. The few recent studies on mortality associated with both uncomplicated and complicated patients with peptic ulcer disease provide contradictory results.
  
  
  
  To evaluate short- and long-term mortality, and the main causes of death in peptic ulcer disease.
  
  
  
  In this retrospective epidemiologic cohort study, register data on 8146 adult patients hospitalised with peptic ulcer disease during 2000-2008 were collected in the capital region of Finland. All were followed in the National Cause of Death Register until the end of 2009. The data were linked with the nationwide Drug Purchase Register of the Finnish Social Insurance Institution.
  
  
  
  Mean follow-up time was 4.9 years. Overall mortality was substantially increased, standardised mortality ratio 2.53 (95% CI: 2.44-2.63); 3.7% died within 30 days, and 11.8% within 1 year. At 6 months, the survival of patients with perforated or bleeding ulcer was lower compared to those with uncomplicated ulcer; hazard ratios were 2.06 (1.68-2.04) and 1.32 (1.11-1.58), respectively. For perforated duodenal ulcers, both the short- and long-term survival was significantly impaired in women. The main causes of mortality at 1 year were malignancies and cardiovascular diseases. Previous use of statins was associated with significant reduction in all-cause mortality.
  
  
  
  One-year mortality in patients hospitalised with peptic ulcer disease remained high with no change. This peptic ulcer disease cohort had a clearly decreased survival rate up to 10 years, especially among women with a perforated duodenal ulcer, most likely explained by poorer survival due to underlying comorbidity.
authors.affiliation: Gastrointestinal Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: H
authors.initials: H
authors.lastname: Malmi
authors.affiliation: Department of General Practice and Primary Health Care, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.|Department of General Practice and Primary Health Care, University of Eastern Finland, Kuopio, Finland.
authors.forename: H
authors.initials: H
authors.lastname: Kautiainen
authors.affiliation: Research Department, The Social Insurance Institution of Finland, Turku, Finland.
authors.forename: L J
authors.initials: LJ
authors.lastname: Virta
authors.affiliation: Helsinki University Clinic of Gastroenterology, University of Helsinki, Helsinki, Finland.
authors.forename: M A
authors.initials: MA
authors.lastname: Färkkilä
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D004381:Duodenal Ulcer / Q000401:mortality; D005260:Female; D005387:Finland / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000453:epidemiology / Q000401:mortality*; D010438:Peptic Ulcer Hemorrhage / Q000453:epidemiology / Q000401:mortality; D010439:Peptic Ulcer Perforation / Q000401:mortality; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors