Abstract

BACKGROUND/AIMS
Even in Japan where the incidence of H. pylori infection is high, patients with gastroduodenal ulcers caused by NSAIDs are on the increase. A prospective study was conducted to elucidate the characteristics of gastroduodenal ulcers complicated with ulcerous hemorrhage and perforation among Japanese.
METHODOLOGY
The subjects were 305 consecutive cases with hemorrhaging ulcers and 76 consecutive cases with perforated ulcers basis at Kagawa Prefectural Central Hospital between January 2000 and December 2008. These subjects were divided into 3 groups (lowdose aspirin, non-aspirin NSAIDs and non-NSAIDs) and were further stratified by the presence of an H. pylori infection.
RESULTS
The 76 perforating ulcers were composed of 54 non-NSAIDs ulcers and 22 NSAIDs-related ulcers. The 305 hemorrhaging ulcers were composed of 156 non-NSAIDs ulcers, 94 non-aspirin NSAIDs ulcers and 55 on low-dose aspirin. The mortality for the non-aspirin NSAIDs group (12.8%, 12/94) and for the low-dose aspirin group (10.9%, 6/55) was significantly higher (p<0.01 and p<0.05, respectively) than the corresponding figure (2.6%, 4/156) for the non-NSAIDs group. The causes of death were exacerbation of or complications from the background diseases (Charlson Co-morbidity Index 3≤) (Odds ratios (OR) 6.01, 95% CI (1.98-18.89)).
CONCLUSIONS
Approximately 50% of the gastroduodenal ulcers with complications found in Japanese are NSAIDs-related and may take a fatal turn. It is necessary to take measures to prevent the complicated ulcers corresponding to risk factors such as the severity of background diseases.

Authors

Ishikawa S, Inaba T, Mizuno M, Miyake Y, Okada H, Ishikawa H, Hori K, Wato M, Kawai K, Yamamoto K

Institution

Department of Gastroenterology and Hepatology, Kagawa Prefectural Central Hospital, Kagawa, Japan.

Source

Hepato-gastroenterology 59:113 pg 147-54

MeSH

Aged
Aged, 80 and over
Anti-Inflammatory Agents, Non-Steroidal
Chi-Square Distribution
Comorbidity
Female
Helicobacter Infections
Helicobacter pylori
Humans
Japan
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Peptic Ulcer
Peptic Ulcer Hemorrhage
Prospective Studies
Risk Assessment
Risk Factors
Time Factors

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22251530