title: Chronic obstructive pulmonary disease is associated with increased recurrent peptic ulcer bleeding risk.
abstract: BACKGROUND
  The association between chronic obstructive pulmonary disease (COPD) and the risk of recurrent peptic ulcer bleeding (PUB) remains unclear. In this study, we compared the risk of recurrent PUB between patients with and those without COPD.
  
  
  METHODS
  Using the Taiwan National Health Insurance Research Database, we first selected patients newly diagnosed with PUB in 2002-2009. Two groups comprising 13,732 COPD cases and 13,732 non-COPD matched controls were created using propensity score matching, thereby making the differences in basic demographics, medication use, and disease conditions between the two groups negligible. Cox proportional hazard regression was used to evaluate the risk of recurrent PUB during the follow-up period.
  
  
  RESULTS
  The cumulative recurrence rate of PUB was significantly higher in the patients with COPD than in the non-COPD matched controls (2years: 10.8% vs 9.3%; 6years: 18.3% vs 15.7%, P all <0.05), with an adjusted hazard ratio (HR) of 1.17 (95% confidence interval [CI], 1.08-1.26, P<0.001) and 1.19 (95% CI, 1.12-1.26, P<0.001) within 2-year and 6-year follow-ups, respectively. Patients with COPD using steroids were at a marginally higher risk of recurrent PUB than those who did not use steroids. Multivariate stratified analysis revealed similar results in many subgroups.
  
  
  CONCLUSIONS
  The risk of recurrent PUB is higher in patients with COPD than in patients without COPD.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Taipei Beitou Health Management Hospital, Taipei, Taiwan; Division of Gastroenterology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
authors.forename: Kuang-Wei
authors.initials: KW
authors.lastname: Huang
authors.affiliation: Department of Neurology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan; Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Kuan
authors.affiliation: Department of Neurology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan; Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Nai-Fang
authors.initials: NF
authors.lastname: Chi
authors.affiliation: Department of Neurology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan; Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Yao-Hsien
authors.initials: YH
authors.lastname: Huang
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Taipei, Veterans General Hospital, Taipei, Taiwan.
authors.forename: Jiing-Chyuan
authors.initials: JC
authors.lastname: Luo
authors.affiliation: School of Health Care Administration, College of Management, Taipei Medical University, Taipei, Taiwan. Electronic address: lnchien@tmu.edu.tw.
authors.forename: Li-Nien
authors.initials: LN
authors.lastname: Chien
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016208:Databases, Factual; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010438:Peptic Ulcer Hemorrhage / Q000453:epidemiology*; D016016:Proportional Hazards Models; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy / Q000453:epidemiology*; D012008:Recurrence; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
chemical_list: D005938:Glucocorticoids
keywords: Chronic obstructive pulmonary disease (COPD); Recurrent peptic ulcer bleeding (PUB); Steroids