Peptic ulcer haemorrhage in Tartu County, Estonia: epidemiology and mortality risk factors

The aim of the study was to assess the epidemiology and mortality risk factors of peptic ulcer haemorrhage (PUH) in Tartu County, Estonia.

In a prospective unselected defined area study, data for 144 patients aged > or = 15 years with new cases of PUH were analysed during a 2-year period.

The incidence of PUH was 57 per 100,000 adult population per year, increasing from 12 in patients aged 20-29 years to more than 135 in those > or = 70 years. The incidence was 2.3-fold higher for men. The incidence of gastric ulcer haemorrhage was 26 (men, 33; women, 20) and that of duodenal ulcer 22 (men, 39; women, 9). Of the women 72% and of the men 37% were > or = 60 years. Nonsteroidal anti-inflammatory drugs (NSAIDs) were used by 45% of the patients (64% of women, 36% of men). Helicobacter pylori infection was present in 93% of the duodenal ulcer patients and in 81% of the gastric ulcer patients. Mortality (8%) was related to age, shock, haemoglobin < 80 g/l, cardiac comorbidity, and recurrence of haemorrhage.

The incidence of PUH is relatively high owing to a high incidence among the younger population in Tartu County. Women with PUH are older, have consumed more NSAIDs, and have mainly gastric ulcer; men are younger, have consumed less NSAIDs, and are prone to duodenal ulcer haemorrhage. H. pylori infection is common in PUH patients. Mortality risk factors coincide with those reported by other researchers.