TY - JOUR
TI - Bleeding duodenal ulcer: comparison between Helicobacter pylori positive
and Helicobacter pylori negative bleeders
AU - Adamopoulos, AB
AU - Efstathiou, SP
AU - Tsioulos, DI
AU - Tzamouranis, DG
AU - and Tsiakou, AG
AU - Tiniakos, D
AU - Mountokalakis, TD
JO - Digestive and Liver Disease
PY - 2004
VL - 36
TODO - 1
SP - 13-20
PB - EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
SN - 1590-8658
TODO - 10.1016/j.dld.2003.09.017
TODO - H. pylori infection; peptic ulcer; upper gastrointestinal bleeding
TODO - Background and aims. To provide a direct comparison of Helicobacter
pylori-positive subjects bleeding from duodenal ulcer with H.
pylori-negative ones, in terms of severity of bleeding and outcome.
Patients and methods. A case-control study was prospectively conducted
in 105 H. pylori-negative duodenal ulcer bleeders and same number of
sex- and age-matched H. pylori-positive ones.
Results. NSAID consumption was more common among H. pylori-negative
subjects (81%) compared to their H. pylori-positive counterparts
(58.1%, P < 0.001). H. pylori-negative bleeders were found to need more
often haemostasis (55.2% versus 31.4%, P < 0.001) or surgical
intervention (15.2% versus 4.8%, P = 0.011) and to have a greater
proportion of rebleeding (32.4% versus 13.3%, P = 0.001), a more
prolonged hospitalisation (11.6 +/- 4.1 versus 6.2 +/- 1.5 days, P <
0.001) and a higher rate of in-hospital mortality (15.2% versus 3.8%,
P = 0.005). In the overall population (N = 210), H. pylori negativity,
among other known risk factors, emerged as independent predictor (odds
ratio: 3.2; 95% CI: 1.5, 11.2; P = 0.004) of an unfavourable outcome
(surgery or death).
Conclusions. Duodenal ulcer bleeding in H. pylori-negative subjects
appears to be more severe, to have a higher rate of rebleeding, and to
lead more often to surgery or fatality compared to the vast majority of
H. pylori-positive duodenal ulcer bleeders. (C) 2003 Editrice
Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights
reserved.
ER -