Systematic review of the epidemiology of complicated peptic ulcer disease

Incidence, recurrence, risk factors and mortality

James Y. Lau, Joseph Sung, Catherine Hill, Catherine Henderson, Colin Howden, David C. Metz

Research output: Contribution to journalReview article

150 Citations (Scopus)

Abstract

Background/Aims: The incidence of uncomplicated peptic ulcer has decreased in recent years. It is unclear what the impact of this has been on the epidemiology of peptic ulcer complications. This systematic review aimed to determine the incidence, recurrence and mortality of complicated peptic ulcer and the risk factors associated with these events. Methods: Systematic PubMed searches. Results: Overall, 93 studies were identified. Annual incidence estimates of peptic ulcer hemorrhage and perforation were 19.4-57.0 and 3.8-14 per 100,000 individuals, respectively. The average 7-day recurrence of hemorrhage was 13.9% (95% CI: 8.4-19.4), and the average long-term recurrence of perforation was 12.2% (95% CI: 2.5-21.9). Risk factors for peptic ulcer complications and their recurrence included nonsteroidal anti-inflammatory drug and/or acetylsalicylic acid use, Helicobacter pylori infection and ulcer size ≥1 cm. Proton pump inhibitor use reduced the risk of peptic ulcer hemorrhage. Average 30-day mortality was 8.6% (95% CI: 5.8-11.4) after hemorrhage and 23.5% (95% CI: 15.5-31.0) after perforation. Older age, comorbidity, shock and delayed treatment were associated with increased mortality. Conclusions: Complicated peptic ulcer remains a substantial healthcare problem which places patients at a high risk of recurrent complications and death.

Original languageEnglish (US)
Pages (from-to)102-113
Number of pages12
JournalDigestion
Volume84
Issue number2
DOIs
StatePublished - Aug 1 2011
Externally publishedYes

Fingerprint

Peptic Ulcer
Epidemiology
Recurrence
Peptic Ulcer Hemorrhage
Mortality
Incidence
Peptic Ulcer Perforation
Hemorrhage
Proton Pump Inhibitors
Helicobacter Infections
PubMed
Helicobacter pylori
Aspirin
Ulcer
Comorbidity
Shock
Anti-Inflammatory Agents
Delivery of Health Care
Pharmaceutical Preparations
Therapeutics

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Systematic review of the epidemiology of complicated peptic ulcer disease : Incidence, recurrence, risk factors and mortality. / Lau, James Y.; Sung, Joseph; Hill, Catherine; Henderson, Catherine; Howden, Colin; Metz, David C.

In: Digestion, Vol. 84, No. 2, 01.08.2011, p. 102-113.

Research output: Contribution to journalReview article

Lau, James Y. ; Sung, Joseph ; Hill, Catherine ; Henderson, Catherine ; Howden, Colin ; Metz, David C. / Systematic review of the epidemiology of complicated peptic ulcer disease : Incidence, recurrence, risk factors and mortality. In: Digestion. 2011 ; Vol. 84, No. 2. pp. 102-113.
@article{0e275b30f8eb4b4b8cd64276f003cb5b,
title = "Systematic review of the epidemiology of complicated peptic ulcer disease: Incidence, recurrence, risk factors and mortality",
abstract = "Background/Aims: The incidence of uncomplicated peptic ulcer has decreased in recent years. It is unclear what the impact of this has been on the epidemiology of peptic ulcer complications. This systematic review aimed to determine the incidence, recurrence and mortality of complicated peptic ulcer and the risk factors associated with these events. Methods: Systematic PubMed searches. Results: Overall, 93 studies were identified. Annual incidence estimates of peptic ulcer hemorrhage and perforation were 19.4-57.0 and 3.8-14 per 100,000 individuals, respectively. The average 7-day recurrence of hemorrhage was 13.9{\%} (95{\%} CI: 8.4-19.4), and the average long-term recurrence of perforation was 12.2{\%} (95{\%} CI: 2.5-21.9). Risk factors for peptic ulcer complications and their recurrence included nonsteroidal anti-inflammatory drug and/or acetylsalicylic acid use, Helicobacter pylori infection and ulcer size ≥1 cm. Proton pump inhibitor use reduced the risk of peptic ulcer hemorrhage. Average 30-day mortality was 8.6{\%} (95{\%} CI: 5.8-11.4) after hemorrhage and 23.5{\%} (95{\%} CI: 15.5-31.0) after perforation. Older age, comorbidity, shock and delayed treatment were associated with increased mortality. Conclusions: Complicated peptic ulcer remains a substantial healthcare problem which places patients at a high risk of recurrent complications and death.",
author = "Lau, {James Y.} and Joseph Sung and Catherine Hill and Catherine Henderson and Colin Howden and Metz, {David C.}",
year = "2011",
month = "8",
day = "1",
doi = "10.1159/000323958",
language = "English (US)",
volume = "84",
pages = "102--113",
journal = "Digestion",
issn = "0012-2823",
publisher = "S. Karger AG",
number = "2",

}

TY - JOUR

T1 - Systematic review of the epidemiology of complicated peptic ulcer disease

T2 - Incidence, recurrence, risk factors and mortality

AU - Lau, James Y.

AU - Sung, Joseph

AU - Hill, Catherine

AU - Henderson, Catherine

AU - Howden, Colin

AU - Metz, David C.

PY - 2011/8/1

Y1 - 2011/8/1

N2 - Background/Aims: The incidence of uncomplicated peptic ulcer has decreased in recent years. It is unclear what the impact of this has been on the epidemiology of peptic ulcer complications. This systematic review aimed to determine the incidence, recurrence and mortality of complicated peptic ulcer and the risk factors associated with these events. Methods: Systematic PubMed searches. Results: Overall, 93 studies were identified. Annual incidence estimates of peptic ulcer hemorrhage and perforation were 19.4-57.0 and 3.8-14 per 100,000 individuals, respectively. The average 7-day recurrence of hemorrhage was 13.9% (95% CI: 8.4-19.4), and the average long-term recurrence of perforation was 12.2% (95% CI: 2.5-21.9). Risk factors for peptic ulcer complications and their recurrence included nonsteroidal anti-inflammatory drug and/or acetylsalicylic acid use, Helicobacter pylori infection and ulcer size ≥1 cm. Proton pump inhibitor use reduced the risk of peptic ulcer hemorrhage. Average 30-day mortality was 8.6% (95% CI: 5.8-11.4) after hemorrhage and 23.5% (95% CI: 15.5-31.0) after perforation. Older age, comorbidity, shock and delayed treatment were associated with increased mortality. Conclusions: Complicated peptic ulcer remains a substantial healthcare problem which places patients at a high risk of recurrent complications and death.

AB - Background/Aims: The incidence of uncomplicated peptic ulcer has decreased in recent years. It is unclear what the impact of this has been on the epidemiology of peptic ulcer complications. This systematic review aimed to determine the incidence, recurrence and mortality of complicated peptic ulcer and the risk factors associated with these events. Methods: Systematic PubMed searches. Results: Overall, 93 studies were identified. Annual incidence estimates of peptic ulcer hemorrhage and perforation were 19.4-57.0 and 3.8-14 per 100,000 individuals, respectively. The average 7-day recurrence of hemorrhage was 13.9% (95% CI: 8.4-19.4), and the average long-term recurrence of perforation was 12.2% (95% CI: 2.5-21.9). Risk factors for peptic ulcer complications and their recurrence included nonsteroidal anti-inflammatory drug and/or acetylsalicylic acid use, Helicobacter pylori infection and ulcer size ≥1 cm. Proton pump inhibitor use reduced the risk of peptic ulcer hemorrhage. Average 30-day mortality was 8.6% (95% CI: 5.8-11.4) after hemorrhage and 23.5% (95% CI: 15.5-31.0) after perforation. Older age, comorbidity, shock and delayed treatment were associated with increased mortality. Conclusions: Complicated peptic ulcer remains a substantial healthcare problem which places patients at a high risk of recurrent complications and death.

UR - http://www.scopus.com/inward/record.url?scp=79953849739&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79953849739&partnerID=8YFLogxK

U2 - 10.1159/000323958

DO - 10.1159/000323958

M3 - Review article

VL - 84

SP - 102

EP - 113

JO - Digestion

JF - Digestion

SN - 0012-2823

IS - 2

ER -