Hospitalizations for peptic ulcer disease in China: Current features and outcomes

Rates and outcomes of hospitalizations for peptic ulcer disease (PUD) are unknown in mainland China. We aimed to describe characteristics and treatments of PUD inpatients in secondary and tertiary care hospitals registered in the national Health Statistics and Information Reporting System in 2015 and to explore factors related to inpatient outcomes.

We retrieved and validated PUD hospitalization data from 4441 hospitals reporting to Health Statistics and Information Reporting System in 2015. Sensitivity analyses were performed to examine the robustness of findings considering different reporting rates across provinces. Current analyses focused on ulcer sites, complications, therapies, and rates of in-hospital death or unauthorized discharge.

Total admissions for PUD were 443 433 (mean age 55.14 years), constituting 0.59% of all-cause hospitalizations of 2015 in 4441 hospitals. Duodenal ulcers were more common than gastric ulcers (44.69% vs 37.42%). About 61% of inpatients had complications (46.45% for bleeding and 14.66% for perforation). Over 96% of uncomplicated or bleeding inpatients were managed medically. Surgery was provided to 64.22% of perforated cases. Endoscopic hemostasis and transcatheter embolization were performed for 1.59% of the bleeding and 0.59% of the perforation cases. For all PUD cases, the average in-hospital mortality was 0.35%. Six percent of inpatients left hospitals without authorization. Multinomial logistic regressions showed that inpatient death and unauthorized discharge were associated with older age, gastric ulcer, bleeding, perforation, and comorbidity after controlling for gender, insurance status, hospital type, area, and region.

Currently, pharmacologic management is dominant, and endoscopic hemostasis is notably underutilized for PUD hospitalizations in mainland China.