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Late mortality in elderly patients surviving acute peptic ulcer bleeding
N Hudson1, G Faulkner, S J Smith
1Department of Therapeutics, University Hospital, Nottingham.
Gut
|August 1, 1995
Summary
Patients discharged after peptic ulcer bleeding have a significantly reduced life expectancy. Excess deaths are mainly from smoking-related diseases, not recurrent ulcer issues.
Area of Science:
- Gastroenterology
- Geriatric Medicine
- Epidemiology
Background:
- Acute peptic ulcer bleeding (PUB) carries high short-term mortality.
- Long-term prognosis after PUB is often assumed to be good with modern treatments.
Purpose of the Study:
- To evaluate the long-term prognosis and mortality of patients over 60 discharged after acute peptic ulcer bleeding.
- To compare mortality rates with age and sex-matched community controls.
Main Methods:
- Study included 487 patients aged over 60 discharged for acute PUB (1986-91) and 480 community controls.
- Follow-up data obtained from hospital records, GP records, and National Health Service central register.
- Mortality compared to controls and expected rates for England and Wales.
Main Results:
- 142 (29%) patients died within a mean follow-up of 34 months, versus 12% of controls (O/E = 1.74).
- Six-year actuarial survival was 50% for ulcer patients vs. 76% for controls.
- Excess mortality primarily due to cancer, respiratory disease, and vascular disease (in men); recurrent ulcer deaths were infrequent.
Conclusions:
- Patients discharged after acute peptic ulcer bleeding have a substantially reduced life expectancy.
- Increased mortality is mainly linked to smoking-related diseases, not recurrent ulcer complications.
- Reduced recurrent ulcer deaths may reflect widespread H2 receptor antagonist use.
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