title: Prevalence of upper gastrointestinal bleeding risk factors among the general population and osteoarthritis patients.
abstract: OBJECTIVE
  To assess the prevalence of possible risk factors of upper gastrointestinal bleeding (UGIB) and their age-group specific trend among the general population and osteoarthritis patients.
  
  
  METHODS
  We utilized data from the National Health Insurance Service that included claims data and results of the national health check-up program. Comorbid conditions (peptic ulcer, diabetes, liver disease, chronic renal failure, and gastroesophageal reflux disease), concomitant drugs (aspirin, clopidogrel, cilostazol, non-steroidal anti-inflammatory drugs, steroid, anticoagulants, and SSRI), personal habits (smoking, and alcohol consumption) were considered as possible UGIB risk factors. We randomly imputed the prevalence of infection in the data considering the age-specific prevalence ofHelicobacter pylori(H. pylori) infection in Korea. The prevalence of various UGIB risk factors and the age-group specific trend of the prevalence were identified. Prevalence was compared between osteoarthritis patients and others.
  
  
  RESULTS
  A total of 801926 subjects (93855 osteoarthritis patients) aged 20 and above were included. The prevalence of individual and concurrent multiple risk factors became higher as the age increased. The prevalence of each comorbid condition and concomitant drug were higher in osteoarthritis patients. Thirty-five point zero two percent of the overall population and 68.50% of osteoarthritis patients had at least one or more risk factors of UGIB. The prevalence of individual and concurrent multiple risk factors in younger age groups were also substantial. Furthermore, when personal habits (smoking, and alcohol consumption) andH. pyloriinfection were included, the prevalence of concurrent multiple risk factors increased greatly even in younger age groups.
  
  
  CONCLUSIONS
  Prevalence of UGIB risk factors was high in elderly population, but was also considerable in younger population. Patient with osteoarthritis was at higher UGIB risk than those without osteoarthritis. Physicians should consider individualized risk assessment regardless of age when prescribing drugs or performing procedures that may increase the risk of UGIB, and take necessary measures to reduce modifiable risk factors such asH. pylorieradication or lifestyle counseling.
authors.affiliation: Sang Hyuck Kim, Jae Moon Yun, Dong Wook Shin, Department of Family Medicine, Seoul National University Hospital, Seoul 03080, South Korea.
authors.forename: Sang Hyuck
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Sang Hyuck Kim, Jae Moon Yun, Dong Wook Shin, Department of Family Medicine, Seoul National University Hospital, Seoul 03080, South Korea.
authors.forename: Jae Moon
authors.initials: JM
authors.lastname: Yun
authors.affiliation: Sang Hyuck Kim, Jae Moon Yun, Dong Wook Shin, Department of Family Medicine, Seoul National University Hospital, Seoul 03080, South Korea.
authors.forename: Chong Bum
authors.initials: CB
authors.lastname: Chang
authors.affiliation: Sang Hyuck Kim, Jae Moon Yun, Dong Wook Shin, Department of Family Medicine, Seoul National University Hospital, Seoul 03080, South Korea.
authors.forename: Heng
authors.initials: H
authors.lastname: Piao
authors.affiliation: Sang Hyuck Kim, Jae Moon Yun, Dong Wook Shin, Department of Family Medicine, Seoul National University Hospital, Seoul 03080, South Korea.
authors.forename: Su Jong
authors.initials: SJ
authors.lastname: Yu
authors.affiliation: Sang Hyuck Kim, Jae Moon Yun, Dong Wook Shin, Department of Family Medicine, Seoul National University Hospital, Seoul 03080, South Korea.
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Shin
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D015897:Comorbidity; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology*; D016481:Helicobacter Infections / Q000453:epidemiology* / Q000382:microbiology; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000188:drug therapy*; D010437:Peptic Ulcer / Q000453:epidemiology; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D057285:Precision Medicine; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D018570:Risk Assessment; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D017367:Selective Serotonin Reuptake Inhibitors
keywords: General population; Osteoarthritis; Prevalence; Risk factor; Upper gastrointestinal bleeding