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High incidence of mortality and recurrent bleeding in patients with Helicobacter pylori-negative idiopathic bleeding ulcers.
Gastroenterology. 2009 Aug; 137(2):525-31.G

Abstract

BACKGROUND & AIMS

The long-term prognosis of peptic ulcers associated with neither Helicobacter pylori nor nonsteroidal anti-inflammatory drugs (NSAIDs) is unknown.

METHODS

This 7-year prospective cohort study recruited patients with bleeding ulcers from January to December 2000. H pylori-negative idiopathic bleeding ulcers were defined as having tested negative for H pylori, having no exposure to aspirin or analgesics within 4 weeks before endoscopy, and having no other identifiable causative factors. After ulcers healed, patients were divided into 2 groups: patients with prior H pylori-negative idiopathic bleeding ulcers (H pylori-negative idiopathic ulcer cohort; n = 120) and those with H pylori-positive, NSAID-negative bleeding ulcers who received eradication therapy (H pylori ulcer cohort; n = 213). Both groups were followed for <or=7 years without gastroprotective therapy. The primary endpoints were recurrent ulcer bleeding and mortality.

RESULTS

The 7-year cumulative incidence of recurrent ulcer bleeding was 42.3% (95% CI, 36.5%-48.1%) in the H pylori-negative idiopathic ulcer cohort and 11.2% (95% CI, 8.8%-13.6%) in the H pylori ulcer cohort (a difference of 31.1%; 95% CI, 27.7%-34.5%; P < .0001). Significantly more patients died in the H pylori-negative idiopathic ulcer cohort (87.6%; 95% CI, 83.0%-92.2%) than in the H pylori ulcer cohort (37.3%; 95% CI, 34.0%-40.6%) with a difference of 50.3% (95% CI, 49.0%-51.6%; P < .0001).

CONCLUSIONS

Patients with history of H pylori-negative idiopathic bleeding ulcers have a high risk of recurrent ulcer bleeding and mortality.

Authors+Show Affiliations

Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong SAR, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19445937

Citation

Wong, Grace Lai-Hung, et al. "High Incidence of Mortality and Recurrent Bleeding in Patients With Helicobacter Pylori-negative Idiopathic Bleeding Ulcers." Gastroenterology, vol. 137, no. 2, 2009, pp. 525-31.
Wong GL, Wong VW, Chan Y, et al. High incidence of mortality and recurrent bleeding in patients with Helicobacter pylori-negative idiopathic bleeding ulcers. Gastroenterology. 2009;137(2):525-31.
Wong, G. L., Wong, V. W., Chan, Y., Ching, J. Y., Au, K., Hui, A. J., Lai, L. H., Chow, D. K., Siu, D. K., Lui, Y. N., Wu, J. C., To, K. F., Hung, L. C., Chan, H. L., Sung, J. J., & Chan, F. K. (2009). High incidence of mortality and recurrent bleeding in patients with Helicobacter pylori-negative idiopathic bleeding ulcers. Gastroenterology, 137(2), 525-31. https://doi.org/10.1053/j.gastro.2009.05.006
Wong GL, et al. High Incidence of Mortality and Recurrent Bleeding in Patients With Helicobacter Pylori-negative Idiopathic Bleeding Ulcers. Gastroenterology. 2009;137(2):525-31. PubMed PMID: 19445937.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High incidence of mortality and recurrent bleeding in patients with Helicobacter pylori-negative idiopathic bleeding ulcers. AU - Wong,Grace Lai-Hung, AU - Wong,Vincent Wai-Sun, AU - Chan,Yawen, AU - Ching,Jessica Yuet-Ling, AU - Au,Kim, AU - Hui,Aric Josun, AU - Lai,Larry Hin, AU - Chow,Dorothy Kai-Lai, AU - Siu,Danny Ka-Fai, AU - Lui,Yan-Ni, AU - Wu,Justin Che-Yuen, AU - To,Ka-Fai, AU - Hung,Lawrence Cheung-Tsui, AU - Chan,Henry Lik-Yuen, AU - Sung,Joseph Jao-Yiu, AU - Chan,Francis Ka-Leung, Y1 - 2009/05/13/ PY - 2009/03/13/received PY - 2009/05/03/revised PY - 2009/05/05/accepted PY - 2009/5/19/entrez PY - 2009/5/19/pubmed PY - 2009/8/14/medline SP - 525 EP - 31 JF - Gastroenterology JO - Gastroenterology VL - 137 IS - 2 N2 - BACKGROUND & AIMS: The long-term prognosis of peptic ulcers associated with neither Helicobacter pylori nor nonsteroidal anti-inflammatory drugs (NSAIDs) is unknown. METHODS: This 7-year prospective cohort study recruited patients with bleeding ulcers from January to December 2000. H pylori-negative idiopathic bleeding ulcers were defined as having tested negative for H pylori, having no exposure to aspirin or analgesics within 4 weeks before endoscopy, and having no other identifiable causative factors. After ulcers healed, patients were divided into 2 groups: patients with prior H pylori-negative idiopathic bleeding ulcers (H pylori-negative idiopathic ulcer cohort; n = 120) and those with H pylori-positive, NSAID-negative bleeding ulcers who received eradication therapy (H pylori ulcer cohort; n = 213). Both groups were followed for <or=7 years without gastroprotective therapy. The primary endpoints were recurrent ulcer bleeding and mortality. RESULTS: The 7-year cumulative incidence of recurrent ulcer bleeding was 42.3% (95% CI, 36.5%-48.1%) in the H pylori-negative idiopathic ulcer cohort and 11.2% (95% CI, 8.8%-13.6%) in the H pylori ulcer cohort (a difference of 31.1%; 95% CI, 27.7%-34.5%; P < .0001). Significantly more patients died in the H pylori-negative idiopathic ulcer cohort (87.6%; 95% CI, 83.0%-92.2%) than in the H pylori ulcer cohort (37.3%; 95% CI, 34.0%-40.6%) with a difference of 50.3% (95% CI, 49.0%-51.6%; P < .0001). CONCLUSIONS: Patients with history of H pylori-negative idiopathic bleeding ulcers have a high risk of recurrent ulcer bleeding and mortality. SN - 1528-0012 UR - https://www.unboundmedicine.com/medline/citation/19445937/High_incidence_of_mortality_and_recurrent_bleeding_in_patients_with_Helicobacter_pylori_negative_idiopathic_bleeding_ulcers_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5085(09)00750-1 DB - PRIME DP - Unbound Medicine ER -