Risk factors and therapeutic response in Chinese patients with peptic ulcer disease

IntroductionIn 2013, peptic ulcer disease (PUD) caused over 300 000 deaths globally. Low-income and middle-income countries are disproportionately affected. However, there is limited information regarding risk factors of perioperative mortality rates in these countries.ObjectiveTo assess perioperative mortality rates from complicated PUD in Africa and associated risk factors.DesignWe performed a systematic review and a random-effect meta-analysis of literature describing surgical management of complicated PUD in Africa. We used subgroup analysis and meta-regression analyses to investigate sources of variations in the mortality rates and to assess the risk factors contributing to mortality.ResultsFrom 95 published reports, 10 037 patients underwent surgery for complicated PUD. The majority of the ulcers (78%) were duodenal, followed by gastric (14%). Forty-one per cent of operations were for perforation, 22% for obstruction and 9% for bleeding. The operations consisted of vagotomy (38%), primary repair (34%), resection and reconstruction (12%), and drainage procedures (6%). The overall PUD mortality rate was 6.6% (95% CI 5.4% to 8.1%). It increased to 9.7% (95% CI 7.1 to 13.0) when we limited the analysis to studies published after the year 2000. The correlation was higher between perforated PUD and mortality rates (r=0.41, p<0.0001) than for bleeding PUD and mortality rates (r=0.32, p=0.001). Non-significant differences in mortality rates existed between sub-Saharan Africa (SSA) and North Africa and within SSA.ConclusionPerioperative mortality rates from complicated PUD in Africa are substantially high and could be increasing over time, and there are possible regional differences.

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Association of Helicobacter Pylori with Peptic Ulcer Perforation

Journal of BP Koirala Institute of Health Sciences ◽

10.3126/jbpkihs.v2i1.24960 ◽

2019 ◽

Vol 2 (1) ◽

pp. 4-10

Author(s):

Sunit Agrawal ◽

D Thakur ◽

P Kafle ◽

A Koirala ◽

R K Sanjana ◽

...

Keyword(s):

Risk Factors ◽

Helicobacter Pylori ◽

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Perforated Peptic Ulcer ◽

Patch Repair ◽

Peptic Ulcer Perforation ◽

Ulcer Disease ◽

Ulcer Perforation ◽

H Pylori

Background: Helicobacter pylori is found in more than 90% cases of peptic ulcer. This study examines the possibility of association of Helicobacter pylori in perforated peptic ulcer disease and its relation to persisting ulcer as well as the influence of other risk factors; namely: smoking, alcohol, current non-steroidal anti inflammatory drugs (NSAIDs) and steroid use. Materials and Methods: In this prospective study, total of 50 cases of peptic ulcer perforation admitted in College of Medical Sciences and Teaching Hospital, Bharatpur, Nepal were selected on the basis of the non-probability (purposive) sampling method. All patients who presented with suspected peptic ulcer perforation were included in the study and the perforations were repaired by Modified Graham’s Patch and were given triple therapy postoperatively. The age, sex, incidence, mode of presentation, precipitating factors, association with the risk factors and postoperative complications were all evaluated and compared. Results: Of 50 patients studied, the age ranged from 17 to 75 years, mean age being 40.1 years with the peak incidence in the 3rd and 5th decades of life showing a male dominance (92%). H. pylori was seen in ulcer edge biopsy in 29 patients (58%). Most common clinical presentation was pain abdomen, the most common signs of perforation were tenderness, rebound tenderness and absent bowel sounds. The mean duration of stay in hospital in H. pylori positive patients was 12.07±8.15 days as compared with 11.1±5.12 days in H. pylori negative patients. The incidence of peptic ulcer perforation was higher in the patients consuming alcohol (64%) than smokers (48%), followed by NSAIDs user(22%). 20% of the patients with delayed presentation developed complications postoperatively. Perforated peptic ulcer was repaired by Modified Graham’s Patch Repair, followed by anti H. pylori therapy in all of them. Conclusion: Peptic ulcer perforation is quite common among the patients with peptic ulcer disease with history of chronic smoking, alcoholism and analgesic intake, more commonly in males. There is association of H. pylori in 58% of patients with peptic ulcer perforation.

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Risk Factors of Peptic Ulcer Disease in Khorramabad city, Southwest of Iran : A Case Control Study

World Family Medicine Journal/Middle East Journal of Family Medicine ◽

10.5742/mewfm.2018.93215 ◽

2018 ◽

Vol 16 (1) ◽

pp. 133-138

Author(s):

Kourosh Ghanadi ◽

Khatereh Anbari

Keyword(s):

Risk Factors ◽

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Case Control Study ◽

Case Control ◽

Ulcer Disease ◽

Southwest Of Iran ◽

Control Study

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Clinical Significance of Risk Factors for Asymptomatic Peptic Ulcer Disease

Clinical Endoscopy ◽

10.5946/ce.2017.159 ◽

2017 ◽

Vol 50 (6) ◽

pp. 514-515

Author(s):

Cheal Wung Huh ◽

Byung-Wook Kim

Keyword(s):

Risk Factors ◽

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Clinical Significance ◽

Ulcer Disease

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Association Between Depression and Recurrence of Peptic Ulcer Disease in Older Chinese Patients after Helicobacter Pylori Eradication: A Three-Year Study

JOURNAL OF MENTAL HEALTH AND CLINICAL PSYCHOLOGY ◽

10.29245/2578-2959/2019/4.1181 ◽

2019 ◽

Vol 3 (4) ◽

pp. 1-9

Author(s):

Wenni Chen ◽

Yu Yu ◽

Ruirui Xu ◽

Hui Han ◽

Gengzhen Chen

Keyword(s):

Helicobacter Pylori ◽

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Chinese Patients ◽

Helicobacter Pylori Eradication ◽

Ulcer Disease ◽

Older Chinese

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Risk Factors For Recurrence of Peptic Ulcer Disease: A Retrospective Study In Tertiary Care Referral Center

10.21203/rs.3.rs-1184031/v1 ◽

2022 ◽

Author(s):

Yaser Alsinnari ◽

Mohammed S. Alqarni ◽

Meshari Attar ◽

Ziad M. Bukhari ◽

Faisal Baabbad ◽

...

Keyword(s):

Risk Factors ◽

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Recurrence Rate ◽

Univariate Analysis ◽

Tertiary Care ◽

Ulcer Disease ◽

Significant Difference ◽

Risk Factors For Recurrence ◽

H Pylori

Abstract Backgrounds: Peptic ulcer disease (PUD) is a common gastrointestinal tract disease characterized by mucosal damage secondary to pepsin and gastric acid secretion. The aim of this study was to evaluate the five-year recurrence rate for treated patients with PUD and risk factors contributing to PUD relapses.Methods: From 2016 through 2021, all patients with endoscopy-proved PUD were identified by reviewing medical records (Best-Care system). Possible risk factors including smoking, non-steroidal anti-inflammatory drugs (NSAIDs), aspirin, alcohol, caffeine, and steroid were analyzed by univariate analysis. Treatment outcomes, 5-year recurrence rate, and mortality rate were assessed.Results: Among 223 patients, there were 187 (83.8%), who diagnosed endoscopy-proved PUD and 36 (16.2%), who diagnosed clinical PUD. Among them, 126 (56.5%) patients were males and the mean age was 62±2 years. The five years recurrence rate of PUD was 30.9%. There was no significant difference in the recurrence rate between the duodenal ulcer (33.3%) and the gastric ulcer (28.8%). By univariate analysis, the use of steroid and NSAID and H. pylori infection were potential risk factors for PUD (P < 0.005). The common complication of PUD was gastrointestinal bleeding (34.1%). Patients who had a complicated PUD were associated with a higher rate of recurrence (45.9%) compared to the uncomplicated PUD (19.2%) (P > 0.05). Conclusion: Our findings demonstrated that the five years recurrence rate of PUD was 30.9%. The use of steroid and NSAID and H. pylori infection were risk factors for recurrence of PUD. PUD places a significant burden on health care systems. Therefore, a multicenter prospective study is needed for effective management to prevent recurrence and complications of PUD.

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