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Risk factors for peptic ulcer bleeding one year after the initial episode
Yu-Xuan Peng1, Wen-Pei Chang2,3
1Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan.
Gut Pathogens
|November 28, 2024
Summary
Older age, severe ulcers, comorbidities, and a history of peptic ulcers or cardiovascular disease increase the risk of peptic ulcer bleeding (PUB) recurrence. Identifying these factors is crucial for preventing readmission.
Area of Science:
- Gastroenterology
- Internal Medicine
- Clinical Research
Background:
- Peptic ulcer bleeding (PUB) is a significant gastrointestinal condition with potential life-threatening complications.
- Recurrence of PUB poses a substantial clinical challenge, necessitating identification of predictive risk factors.
- Understanding these risk factors is vital for improving patient outcomes and reducing healthcare burdens.
Purpose of the Study:
- To identify independent risk factors associated with the recurrence of peptic ulcer bleeding (PUB).
- To analyze patient data retrospectively to determine predictors of readmission due to recurrent PUB within one year.
- To provide evidence-based insights for clinical management and preventative strategies for PUB patients.
Main Methods:
- Retrospective analysis of medical records for 775 patients admitted with PUB between January 1, 2020, and December 31, 2022.
- Utilized a multivariate logistic regression model to identify independent risk factors for 1-year readmission due to recurrent PUB.
- Compared characteristics of patients readmitted for PUB with those not readmitted.
Main Results:
- Independent risk factors for 1-year PUB readmission included age 70 or above (OR=1.62), severe ulcer classification (Forrest 1a-2b) (OR=2.41), and a Charlson Comorbidity Index (CCI) score of 3 or higher (OR=2.25).
- A history of peptic ulcers (OR=3.87), history of cardiovascular disease (CVD) (OR=2.31), and admission international normalized ratio (INR) > 1.2 (OR=2.14) were also significant predictors of readmission.
- Conversely, younger age, less severe ulcers, lower CCI scores, no history of peptic ulcers or CVD, and admission INR ≤ 1.2 were associated with lower readmission rates.
Conclusions:
- Age (≥70 years), severe ulcer classification (Forrest 1a-2b), multiple comorbidities (CCI ≥ 3), prior peptic ulcer history, CVD history, and elevated admission INR (>1.2) are confirmed independent risk factors for recurrent PUB.
- These findings highlight the importance of considering patient demographics, ulcer severity, comorbidity burden, and specific clinical markers in predicting PUB recurrence.
- The study underscores the need for targeted monitoring and management strategies for high-risk PUB patients to prevent readmission.
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