Time-trends in the epidemiology of peptic ulcer bleeding.

Abstract

OBJECTIVE:

Despite the introduction of effective medical treatment of peptic ulcer disease, bleeding is still a frequent complication. The aim of this study was to investigate whether the incidence and the risk profile of peptic ulcer haemorrhage have changed within a 10-year period.

MATERIAL AND METHODS:

In a prospective epidemiological and observational study the incidence and risk profile of peptic ulcer haemorrhage in Düsseldorf, Germany were compared between two time periods (period A: 1.3.89-28.2.90 and period B: 1.4.99-31.3.2000), involving nine hospitals with both surgical and medical departments. Patients with proven peptic ulcer haemorrhage at endoscopy or operation were included in the study; those with bleeding under defined severe stress conditions were excluded.

RESULTS:

No differences in bleeding ulcer incidence were observed between periods A and B (51.4 per 100,000 person-years versus 48.7), or for duodenal ulcer (24.9 versus 25.7) or for gastric ulcer bleeding (26.5 versus 23.0). A marked increase in incidence rates was observed with increasing age. In period B, patients with bleeding ulcers were older (56% versus 41% 70 years or older), were usually taking non-steroidal anti-inflammatory drugs (NSAIDs) (45% versus 27%) and were less likely to have a history of ulcer (25% versus 59%) compared with patients in period A.

CONCLUSIONS:

The persisting high incidence of peptic ulcer disease is a superimposing of two trends: a higher incidence in the growing population of elderly patient with a higher intake of NSAIDs and a lower incidence among younger patients due to a decrease in incidence and improved medical treatment.

• Authors: Christian Ohmann, Michael Imhof, Christian Ruppert, Ulf Janzik, Christoph Vogt, Thomas Frieling, Klaus Becker, Frank Neumann, Stephan Faust, Klaus Heiler, Klaus Haas, Rainer Jurisch, Ernst-Günter Wenzel, Stefan Normann, Oliver Bachmann, Jorge Delgadillo, Florian Seidel, Claus Franke, Reinhard Lüthen, Qin Yang, Christian Reinhold
• Journal: Scandinavian journal of gastroenterology (Scand J Gastroenterol) Vol. 40 Issue 8 Pg. 914-20 (Aug 2005) ISSN: 0036-5521 [Print] England
• PMID: 16165708 (Publication Type: Comparative Study, Journal Article, Multicenter Study)

Topics

• Adult
• Age Distribution
• Aged
• Aged, 80 and over
• Duodenal Ulcer (complications, diagnosis, epidemiology)
• Endoscopy, Gastrointestinal
• Female
• Germany (epidemiology)
• Humans
• Incidence
• Male
• Middle Aged
• Observation
• Peptic Ulcer Hemorrhage (diagnosis, epidemiology, etiology)
• Prospective Studies
• Risk Factors
• Sex Distribution
• Stomach Ulcer (complications, diagnosis, epidemiology)
• Time Factors