Helicobacter pylori (H. pylori) testing in patients with bleeding ulcers is recommended by society guidelines and considered a quality indicator.
Dr John Kim and colleagues from California, USA examined the proportion of patients with bleeding ulcers who had H. pylori testing, and identified predictors associated with H. pylori testing.
Consecutive hospitalized patients with bleeding ulcers documented endoscopically at a single center from 10/2004-5/2011 were identified retrospectively from an endoscopy database.
The proportion of patients undergoing direct H. pylori testing, and any H. pylori testing were determined.
|86% had biopsy-based testing during the initial endoscopy|
Among 330 patients with bleeding ulcers, 105 underwent direct testing and another 52 had serologic testing during a median follow-up of 9 months.
The team found that H. pylori testing occurred at the index hospitalization in 93% of the 157 patients tested.
Among the 105 patients who had direct H. pylori testing, 86% had biopsy-based testing during the initial endoscopy.
The researchers noted that undergoing biopsy of a gastric ulcer was strongly associated with having direct H. pylori testing performed.
Dr Kim's team concludes, "Among patients hospitalized with bleeding ulcers, less than half received H. pylori testing and less than a third received the more accurate direct testing."
"Most of the direct H. pylori testing was biopsy-based with very few being tested after the index hospitalization."
"Efforts to increase H. pylori testing in patients with bleeding ulcers are needed to improve outcomes."