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News

Comorbidity influences mortality in patients with peptic ulcer bleeding

This month's issue of the American Journal of Gastroenterology effects comorbidity on mortality in patients with peptic ulcer bleeding.

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By systematic review and meta-analysis, Dr Grigorios Leontiadis and colleagues from Illinois, USA evaluated the impact of comorbidity on short-term mortality in patients with peptic ulcer bleeding.

The research team conducted systematic searches in PubMed and Embase.

Relative risks were pooled across selected studies and an analysis of diagnostic test accuracy was performed to validate the results further.

Of 1,572 identified studies, 16 were eligible for inclusion.

Peptic ulcer bleeding patients with 3 or more comorbidities had a greater risk of dying
American Journal of Gastroenterology

Only 3 had a low risk of bias and the overall quality of evidence was low.

The risk of death was significantly greater in  peptic ulcer bleeding patients with comorbidity than in those without.

The pooled sensitivity for comorbidity predicting death in patients with peptic ulcer bleeding was 0.9, and the pooled specificity was 0.5.

The research team noted that peptic ulcer bleeding patients with 3 or more comorbidities had a greater risk of dying than those with 1 or 2.

All individual comorbidities that the team assessed significantly increased the risk of death associated with peptic ulcer bleeding.

However, the team found that relative risks were higher for hepatic, renal, and malignant disease.

Dr Leontiadis' team commented, "Underlying comorbidity is consistently associated with increased mortality in patients with peptic ulcer bleeding."

"The number and type of comorbidities in patients with  peptic ulcer bleeding should be carefully evaluated and factored into initial management strategies."

Am J Gastroenterol 2013; 108: 331–345
14 March 2013

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