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Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 2000 Feb;54(2):130–133. doi: 10.1136/jech.54.2.130

Overall mortality among patients surviving an episode of peptic ulcer bleeding

A Ruigomez 1, L A Rodriguez 1, G Hasselgren 1, S Johansson 1, M Wallander 1
PMCID: PMC1731615  PMID: 10715746

Abstract

STUDY OBJECTIVE—The authors investigated whether patients who have survived an acute episode of peptic ulcer bleeding (PUB) have an excess long term all cause mortality compared with the general population free of PUB.
DESIGN—Follow up study of previously identified cohort of patients with a PUB episode and a general population cohort.
SETTING—The source population included all people aged 30 to 89 years, registered with general practitioners in the United Kingdom.
PATIENTS—All patients alive one month after the PUB episode constituted the cohort of PUB patients (n=978). A control group of 5000 people was randomly sampled from the source population. The same eligibility criteria as for patients with PUB were applied to the control series. Also, controls had to be free of PUB before start date.
MAIN RESULTS—Relative risk of mortality among PUB patients was 2.1, 95%CI: 1.7, 2.6) compared with the general population. This increased mortality risk occurred mainly in the patients less than 60 years old. No difference was observed between men and women. The excess mortality was not only circumscribed to deaths attributable to recurrent gastrointestinal bleed, but also cardiovascular, cancer and other causes.
CONCLUSIONS—People who have survived an acute episode of PUB have a reduced long term survival compared with the general population.This reduction was stronger among middle age patients than in the elderly.


Keywords: cohort study; mortality; peptic ulcer; bleeding; population-based study

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Selected References

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  1. Branicki F. J., Coleman S. Y., Fok P. J., Pritchett C. J., Fan S. T., Lai E. C., Mok F. P., Cheung W. L., Lau P. W., Tuen H. H. Bleeding peptic ulcer: a prospective evaluation of risk factors for rebleeding and mortality. World J Surg. 1990 Mar-Apr;14(2):262–270. doi: 10.1007/BF01664889. [DOI] [PubMed] [Google Scholar]
  2. Englund R., Fisher R. Survival following perforation of peptic ulcer. Aust N Z J Surg. 1990 Oct;60(10):795–800. doi: 10.1111/j.1445-2197.1990.tb07476.x. [DOI] [PubMed] [Google Scholar]
  3. Fischer I., Madsen M. R., Thomsen H., Høst V., Wara P. Peptic ulcer hemorrhage: factors predisposing to recurrence. Scand J Gastroenterol. 1994 May;29(5):414–418. doi: 10.3109/00365529409096831. [DOI] [PubMed] [Google Scholar]
  4. García Rodríguez L. A., Jick H. Risk of upper gastrointestinal bleeding and perforation associated with individual non-steroidal anti-inflammatory drugs. Lancet. 1994 Mar 26;343(8900):769–772. doi: 10.1016/s0140-6736(94)91843-0. [DOI] [PubMed] [Google Scholar]
  5. García Rodríguez L. A., Ruigómez A., Hasselgren G., Wallander M. A., Johansson S. Comparison of mortality from peptic ulcer bleed between patients with or without peptic ulcer antecedents. Epidemiology. 1998 Jul;9(4):452–456. doi: 10.1097/00001648-199807000-00018. [DOI] [PubMed] [Google Scholar]
  6. Hudson N., Faulkner G., Smith S. J., Langman M. J., Hawkey C. J., Logan R. F. Late mortality in elderly patients surviving acute peptic ulcer bleeding. Gut. 1995 Aug;37(2):177–181. doi: 10.1136/gut.37.2.177. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Hunt P. S., Hansky J., Korman M. G. Mortality in patients with haematemesis and melaena: a prospective study. Br Med J. 1979 May 12;1(6173):1238–1240. doi: 10.1136/bmj.1.6173.1238. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Jick H., Jick S. S., Derby L. E. Validation of information recorded on general practitioner based computerised data resource in the United Kingdom. BMJ. 1991 Mar 30;302(6779):766–768. doi: 10.1136/bmj.302.6779.766. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Katschinski B., Logan R., Davies J., Faulkner G., Pearson J., Langman M. Prognostic factors in upper gastrointestinal bleeding. Dig Dis Sci. 1994 Apr;39(4):706–712. doi: 10.1007/BF02087411. [DOI] [PubMed] [Google Scholar]
  10. Perry I. J., Wannamethee S. G., Walker M. K., Thomson A. G., Whincup P. H., Shaper A. G. Prospective study of risk factors for development of non-insulin dependent diabetes in middle aged British men. BMJ. 1995 Mar 4;310(6979):560–564. doi: 10.1136/bmj.310.6979.560. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Rockall T. A., Logan R. F., Devlin H. B., Northfield T. C. Incidence of and mortality from acute upper gastrointestinal haemorrhage in the United Kingdom. Steering Committee and members of the National Audit of Acute Upper Gastrointestinal Haemorrhage. BMJ. 1995 Jul 22;311(6999):222–226. doi: 10.1136/bmj.311.6999.222. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Rockall T. A., Logan R. F., Devlin H. B., Northfield T. C. Risk assessment after acute upper gastrointestinal haemorrhage. Gut. 1996 Mar;38(3):316–321. doi: 10.1136/gut.38.3.316. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Rørbaek-Madsen M., Fischer L., Thomsen H., Wara P. Late outcome of bleeding gastric ulcer. Five to eight years' follow-up. Scand J Gastroenterol. 1994 Nov;29(11):983–987. doi: 10.3109/00365529409094874. [DOI] [PubMed] [Google Scholar]
  14. Smart H. L., Langman M. J. Late outcome of bleeding gastric ulcers. Gut. 1986 Aug;27(8):926–928. doi: 10.1136/gut.27.8.926. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Welch H. G., Albertsen P. C., Nease R. F., Bubolz T. A., Wasson J. H. Estimating treatment benefits for the elderly: the effect of competing risks. Ann Intern Med. 1996 Mar 15;124(6):577–584. doi: 10.7326/0003-4819-124-6-199603150-00007. [DOI] [PubMed] [Google Scholar]

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