The incidence and complications of peptic ulcer disease have declined, but mortality from bleeding ulcers has remained unchanged.
Dr Hannaa Malmi and colleagues evaluated the significance of peptic ulcer disease among patients admitted for acute upper endoscopy and to evaluate the survival of peptic ulcer disease patients.
The research team examined a prospective, observational cohort study, data on 1580 acute upper endoscopy cases during 2012–2014 were collected.
A total of 649 patients were included with written informed consent.
The team collected data on patients’ characteristics, living habits, comorbidities, drug use, endoscopy and short-term and long-term survival.
|35% had major stigmata of bleeding in endoscopy|
|European Journal of Gastroenterology & Hepatology|
Of all patients admitted for endoscopy, 23% had peptic ulcer disease with the main symptom of melena.
Of these peptic ulcer disease patients, 35% had major stigmata of bleeding in endoscopy.
The researchers noted that patients with major stigmata had significantly more often renal insufficiency, lower level of blood pressure with tachycardia and lower level of hemoglobin, platelets and ratio of thromboplastin time.
No differences in drug use, Charlson comorbidity class, BMI, smoking or alcohol use were found. Of the peptic ulcer disease patients, 31% were Helicobacter pylori positive.
The 30-day mortality was less than 1%, 1-year mortality was 13%, and the 2-year mortality was 19%, with no difference according to major or minor stigmata of bleeding.
The research team found that comorbidity was associated with decreased survival, and obesity was associated with better survival.
Dr Malmi's team concludes, "Peptic ulcer disease is still the most common cause for acute upper endoscopy with very low short-term mortality."
"Comorbidity, but not the stigmata of bleeding, was associated with decreased long-term survival."