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. 2017 Jun;33(3):221-226.
doi: 10.1159/000475450. Epub 2017 Jun 16.

Gastric Ulcer Complications after the Introduction of Proton Pump Inhibitors into Clinical Routine: 20-Year Experience

Friederike Eisner  1 , Diana Hermann  1 , Khaled Bajaeifer  2 , Jörg Glatzle  2 , Alfred Königsrainer  1 , Markus A Küper  3
Affiliations

Gastric Ulcer Complications after the Introduction of Proton Pump Inhibitors into Clinical Routine: 20-Year Experience

Friederike Eisner et al. Visc Med. 2017 Jun.

Abstract

Background: The aim of this study was to analyze the admissions and the management of peptic ulcer disease (PUD) in a tertiary care surgical center.

Methods: We evaluated the medical records of all patients admitted to the University Hospital of Tübingen, Germany, for treatment of PUD during 1989-2008. Patients were included into the study if the diagnosis was verified endoscopically or surgically. Annual number of admissions, length of hospitalization, mortality rate, age, rate of non-steroidal anti-inflammatory drugs (NSAIDs) and proton pump inhibitor (PPI) medication, rate of Helicobacter pylori infection, and complications of PUD and surgery performed were recorded. Data were analyzed by descriptive analyses, Pearson's chi-square test, and regression analysis.

Results: This study included 614 admissions. The number of annual admissions (31 ± 12), the length of hospitalization (9 ± 3 days), and the mortality rate (5 ± 4% per year) remained constant, whereas the age increased (1989: 52 ± 14 years vs. 2008: 67 ± 16 years). The rates of patients with H. pylori infection (47 ± 28% per year), NSAIDs treatment (29 ± 15% per year), and PPI treatment (31 ± 27% per year) remained constant. The most frequent PUD complication was hemorrhage (42 ± 16% per year), followed by perforation (9 ± 8% per year). During 1999-2008, more hemorrhages (125 vs. 121; p < 0.05) and perforations (40 vs. 21; p < 0.05) were registered than during 1989-1998. The rate of emergency surgery increased from 70% during 1989-1998 to 87% during 1999-2008. In contrast, elective surgery decreased from 21% during 1989-1998 to 7% during 1999-2008. Ulcer excision and oversewing was the most frequent surgical procedure performed (59%), with decreasing rates of acid-reducing surgery.

Conclusion: Despite recent advances in PUD management, ulcer hemorrhage and perforation remain a significant health burden and a surgical disease.

Keywords: Helicobacter pylori; Non-steroidal anti-inflammatory drugs, NSAIDs; Peptic ulcer disease; Surgical oversewing; Ulcer excision; Ulcer hemorrhage; Ulcer perforation.

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Figures

Fig. 1
Fig. 1
Annual admission for peptic ulcer disease.
Fig. 2
Fig. 2
Mean age of the patients hospitalized for peptic ulcer disease.
Fig. 3
Fig. 3
Mean length of hospital stay for complicated peptic ulcer disease.
Fig. 4
Fig. 4
Annual rates of ulcer complications.
See this image and copyright information in PMC

References

    1. Sung JJY, Kuipers EJ, El-Serag HB. Systematic review: the global incidence and prevalence of peptic ulcer disease. Aliment Pharmacol Ther. 2009;29:938–946. - PubMed
    1. Søreide K, Thorsen K, Søreide JA. Strategies to improve the outcome of emergency surgery for perforated peptic ulcer. Br J Surg. 2014;101:e51–64. - PubMed
    1. Wang YR, Richter JE, Dempsey DT. Trends and outcomes of hospitalizations for peptic ulcer disease in the United States, 1993 to 2006. Ann Surg. 2010;251:51–58. - PubMed
    1. Yuan Y, Padol IT, Hunt RH. Peptic ulcer disease today. Nat Clin Pract Gastroenterol Hepatol. 2006;3:80–89. - PubMed
    1. Ramakrishnan K, Salinas RC. Peptic ulcer disease. Am Fam Physician. 2007;76:1005–1012. - PubMed

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