Cirrhotic patients at increased risk of peptic ulcer bleeding: a nationwide population-based cohort study
Alimentary Pharmacology and Therapeutics, 07/27/2012
Luo JC et al. – Cirrhotic patients have a significantly higher risk of peptic ulcer bleeding after adjustments for possible confounding factors like age, gender, economic status, underlying comorbidities and ulcerogenic medication.Methods
- Using the National Health Insurance Research Database, a nationwide population–based dataset in Taiwan and matching age, gender, comorbidities and ulcerogenic medication by propensity score, 4013 cirrhotic patients, 8013 chronic hepatitis patients and 7793 normal controls were compared.
- The log–rank test was used to analyse differences in accumulated PUB–free survival rates between the groups.
- Cox proportional hazard regressions were performed to evaluate independent risk factors for PUB in all patients and identified risk factors of PUB in cirrhotic patients.
- During the 7–year follow–up, cirrhotic patients had significantly higher incidences of PUB than chronic hepatitis patients and controls, respectively (P < 0.001 by log–rank test).
- By Cox proportional hazard regression analysis, cirrhosis was independently associated with increased risk of PUB (hazard ratio: 4.22; 95% CI 3.37–5.29, P < 0.001) after adjusting for age, gender, economic status, underlying comorbidities and ulcerogenic medication.
- Age, male, diabetes, chronic renal disease, history of gastro–oesophageal variceal bleeding and use of nonsteroidal anti–inflammatory drugs were risk factors for PUB in cirrhotic patients.