Oral glucocorticoids increase mortality with peptic ulcers

Pre-admission use of oral glucocorticoids is associated with up to a 2-fold increase in 30-day mortality among patients hospitalized with perforated peptic ulcer, reports the latest issue of Alimentary Pharmacology & Therapeutics.

There is evidence that use of glucocorticoids increases the risk of complicated peptic ulcer disease.

However, limited data exist on how use of oral glucocorticoids affects outcome for patients with peptic ulcer perforation.

Dr Christensen and colleagues examined 30-day mortality from peptic ulcer perforation.

The researchers compared pre-admission oral glucocorticoid users with non-users from population-based discharge registries in 3 Danish counties.

The research team identified 2061 patients with a first-time hospital discharge diagnosis of perforated peptic ulcer.

Overall 30-day mortality rate was 25% vs 39% among current glucocorticoid users

Alimentary Pharmacology & Therapeutics

Data on use of glucocorticoids and other ulcer-related drugs, previous hospitalizations for uncomplicated peptic ulcer disease were obtained.

The team also evaluated comorbidity data from discharge registries and prescription databases.

Follow-up data on mortality were provided by the Danish Civil Registry System.

A total of 228 patients were exposed to glucocorticoids within 60 days of admission.

Overall 30-day mortality rate was 25%, and the corresponding rate among current glucocorticoid users was 39%.

Compared with 'never users', the team found that the adjusted mortality ratio among current users of oral glucocorticoids alone was 2.

The researchers observed that among current users of oral glucocorticoids in combination with other ulcer-related drugs the mortality ratio was 1.5.

Dr Christensen's team commented, “Pre-admission use of oral glucocorticoids is associated with up to a twofold increase in 30-day mortality among patients hospitalized with perforated peptic ulcer.”