Analysis of the risk factors and their combinations in acute gastroduodenal ulcer bleeding: A case-control study
| Autor: | Markku Heikkinen, Antero Palmu, Harri Mustonen, Marianne Udd, Riitta Tarvainen, Risto Julkunen, Pekka Miettinen, E Janatuinen, Pentti Pasanen |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Adult
Male medicine.medical_specialty Alcohol Drinking Gastroenterology Statistics Nonparametric Helicobacter Infections 03 medical and health sciences 0302 clinical medicine Risk Factors Surveys and Questionnaires Internal medicine medicine Humans CagA 030212 general & internal medicine Risk factor Analgesics Dose-Response Relationship Drug Helicobacter pylori medicine.diagnostic_test business.industry Anti-Inflammatory Agents Non-Steroidal Smoking Warfarin Case-control study Anticoagulants medicine.disease Thrombosis digestive system diseases 3. Good health Endoscopy Duodenal ulcer Logistic Models Peptic Ulcer Hemorrhage Acute Disease Female 030211 gastroenterology & hepatology Peptic ulcer bleeding business medicine.drug |
| Zdroj: | Scandinavian Journal of Gastroenterology. 42:1395-1403 |
| ISSN: | 1502-7708 0036-5521 |
| Popis: | Traditional non-steroidal anti-inflammatory drugs (NSAIDs) including ASA for thrombosis prophylaxis (ASA-TP), for pain medication (ASA-P) or non-ASA NSAIDs (NANSAIDs), Helicobacter pylori infection, CagA strains of H. pylori and smoking are reported risk factors for peptic ulcer bleeding (PUB), but the combined and the dose effects of these factors are controversial. The aim of this study was to estimate the significance of these risk factors and their combinations in PUB.PUB patients (n = 94) were compared with an age- (+/- 5 years) and gender-matched control group of non-ulcer patients (n = 94) attending elective endoscopy. A questionnaire on the possible risk factors (previous gastric and duodenal ulcer, use of ASA-TP, ASA-P, NANSAIDs, warfarin, alcohol and smoking) was completed. H. pylori infection was determined as positive if histology and/or urease tests were positive. CagA antibodies of IgG class were determined using an immunoblot method.H. pylori infection (odds ratio (OR) 8.8), the use of ASA-P (OR 3.5), ASA-TP (OR 4.07), NANSAIDs withor =1 defined daily dose (OR 6.56), smokingor =20 cigarettes daily (OR 6.43) and previous duodenal ulcer (DU) (OR 8.96) were independent risk factors for PUB. At least two risk factors were present in 65% of PUB patients. CagA strains were detected in 97% of the H. pylori-positive cases and in 96% of the respective controls. ASA, ibuprofen, ketoprofen and smoking were dose-dependent risk factors for PUB.Previous DU, H. pylori, the use of any ASA and smoking explained the majority of the PUB episodes. CagA strains of H. pylori were not associated with PUB. Two-thirds of the PUB patients had at least two risk factors, but their combination did not potentiate the risk. |
| Databáze: | OpenAIRE |
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