Analysis of Risk Factors of the Peptic Ulcer Bleeding

Kim, In Han; Kim, Pum Soo; Kwon, Sook; Lee, Don Haeng; Choi, Won; Cho, Hyeon Guen; Kim, Hyung Gil; Shin, Yong Woon; Kim, Young Soo; Kim, Young Bae

Abstract

BACKGROUND/AIMS
Use of nonsteroidal anti-inflammatory drugs (NSAIDs) is known to be associated with a high incidence of upper gastrointestinal tract bleeding in the elderly. Increase in prevalence of Helicobacter pylori (H. pylori) infection according to age, implicates that an interaction between use of NSAIDs and H. pylori infection may explain the higher incidence of ulcer complications in the elderly. In the present study, we analysed risk factors existed in peptic ulcer patients with upper gastrointestinal bleeding. METHODS: A retrospective study was performed for 420 consecutive peptic ulcer patients (bleeding: 98, nonbleeding: 322). The bleeding group had bleeding symptoms and endoscopic stigmata of bleeding. Use of NSAIDs was evaluated by interview and H. pylori infection was confirmed by endoscopic biopsy specimens and CLO test in all cases. RESULTS: The rates of duodenal ulcer were 62.5% in bleeding group and 50.5% in nonbleeding group (p<0.05). NSAIDs and H. pylori-infection didn't show a significant correlation with bleeding (p>0.05). However, CagA showed a positive correlation with the peptic ulcer bleeding, especially gastric ulcer bleeding (p<0.05).
CONCLUSIONS
In peptic ulcer patients, duodenal ulcer is more prone to bleeding than gastric ulcer. Use of NSAIDs doesn't increase the risk of upper gastrointestinal bleeding. Location of ulcer and CagA positivity seem to be risk factors of upper gastrointestinal bleeding.