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Incidence and 30-day mortality of peptic ulcer bleeding in Korea.

Authors
 Bae, Seung Jin  ;  Kim, Nayoung  ;  Kang, Jung Mook  ;  Kim, Dong-Sook  ;  Kim, Kyoung-Min  ;  Cho, Yu Kyung  ;  Kim, Jie-Hyun  ;  Jung, Sung Woo  ;  Shim, Ki-Nam 
Citation
 EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY, Vol.24(6) : 675-682, 2012 
Journal Title
EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY
ISSN
 0954-691X 
Issue Date
2012
MeSH
Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Algorithms ; Child ; Child, Preschool ; Female ; Hospitalization/statistics & numerical data ; Humans ; Incidence ; Infant ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Peptic Ulcer Hemorrhage/diagnosis ; Peptic Ulcer Hemorrhage/epidemiology* ; Peptic Ulcer Hemorrhage/mortality ; Republic of Korea/epidemiology ; Retrospective Studies ; Sex Distribution
Keywords
bleeding ; incidence ; mortality ; peptic ulcer
Abstract
OBJECTIVES: To estimate the rates of peptic ulcer bleeding (PUB) incidence and the association of demographic factors with 30-day mortality after PUB.

METHODS: Diagnostic algorithms for PUB were derived and validated on the basis of 115 true PUB patients at one tertiary hospital in 2005, followed by estimation of age-specific PUB incidence and 30-day mortality rates, using the Korean National Health Insurance claim database. A Cox proportional hazard model was used to determine the impact of demographic factors on the 30-day mortality rate ratio (MRR) after PUB.

RESULTS: The diagnostic algorithm showed 89 and 88% positive predictive value and sensitivity, respectively. On the basis of this algorithm, the rate of PUB incidence was 22.1 per 100 000 during 2006-2007 and the age-specific incidence rate increased with advanced age. This incidence rate was more than three times higher among men than women. Among 21 107 PUB patients, the overall 30-day mortality rate was 2.15%, but it ranged from 0.83% for patients younger than 60 years to 7.65% for patients older than 80 years. The adjusted 30-day mortality rate ratio for patients older than 80 was 8.13 (95% confidence interval 6.10-10.8) compared with those younger than 60 and 7.09 (95% confidence interval 2.78-4.51) for patients with a high level of comorbidity compared with a low level of comorbidity.

CONCLUSION: PUB incidence was higher among men and increased with advanced age. Increased 30-day mortality was observed in association with increasing age, after adjusting for comorbidity.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00042737-201206000-00010&LSLINK=80&D=ovft
DOI
22441511
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jie-Hyun(김지현) ORCID logo https://orcid.org/0000-0002-9198-3326
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/90198
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