Portal de Periódicos da CAPES

Risk Factors of Peptic Ulcer in 4943 Inpatients

2008; Lippincott Williams & Wilkins; Volume: 42; Issue: 4 Linguagem: Inglês

10.1097/mcg.0b013e3180318ac5

1539-2031

G. Talamini, Marina Tommasi, Valeria Amadei, Benedetta Pajusco, Anna Fratucello, Alessandro Lechi, Giovanna Scroccaro, Italo Vantini,

Gastroesophageal reflux and treatments

Background Over the past few years, major changes have taken place in the treatment of gastroduodenal peptic ulcer. Aim To evaluate risk factors associated with the incidence of peptic ulcer in inpatients. Methods From 2001 to 2004, the number of prescriptions of H2-antagonists and proton pump inhibitors (PPIs) in each department of Verona University Hospital was monitored. Over the same period we prospectively recorded the number of upper endoscopies per department for inpatients with a diagnosis of peptic ulcer. Results We analyzed 4943 inpatients. A significantly decreasing trend in H2-antagonist prescriptions (r=−0,88; P<0.001) and an increasing trend in PPI prescriptions (r=0.97; P<0.001) were observed. The endoscopic incidence of duodenal ulcers decreased linearly from 2001 to 2004 as follows: 6.5% (94/1439) in 2001, 5.6% (82/1473) in 2002, 4.5% (63/1411) in 2003, and 3.1% (22/702) (P<0.001) in 2004. Gastric ulcer incidence, sex, age, indication for endoscopy, use of nonsteroidal anti-inflammatory drugs (NSAIDs), presence of Helicobacter pylori (32%), and smoking and drinking habits showed no significant changes over the study period. Considering time-dependent variables, multivariate regression analysis identified only PPI use and NSAID use as factors predictive of duodenal ulcer but not of gastric ulcer. Conclusions In inpatients, PPIs are associated with a reduced risk of duodenal ulcer, whereas NSAIDs are associated with an increased risk. Gastric ulcer was not associated with any increased or degreased risk with the 2 above-mentioned variables.