Gut Liver.  2015 May;9(3):346-352. 10.5009/gnl13451.

Helicobacter pylori Eradication within 120 Days Is Associated with Decreased Complicated Recurrent Peptic Ulcers in Peptic Ulcer Bleeding Patients

Affiliations
  • 1Division of Gastroenterology, Taipei City Hospital Yang-Ming Branch, Taipei, Taiwan.
  • 2Department of Internal Medicine, Taipei City Hospital Yang-Ming Branch, Taipei, Taiwan.
  • 3School of Medicine, National Yang-Ming University, Taipei, Taiwan.
  • 4Department of Education and Research, Taipei City Hospital, Taipei, Taiwan. hyhu@ym.edu.tw
  • 5Institute of Public Health and Department of Public Health, National Yang-Ming University, Taipei, Taiwan.

Abstract

BACKGROUND/AIMS
The connection between Helicobacter pylori and complicated peptic ulcer disease in peptic ulcer bleeding (PUB) patients taking nonsteroidal anti-inflammatory drugs has not been established. In this study, we sought to determine whether delayed H. pylori eradication therapy in PUB patients increases complicated recurrent peptic ulcers.
METHODS
We identified inpatient PUB patients using the Taiwan National Health Insurance Research Database. We categorized patients into early (time lag < or =120 days after peptic ulcer diagnosis) and late H. pylori eradication therapy groups. The Cox proportional hazards model was used. The primary outcome was rehospitalization for patients with complicated recurrent peptic ulcers.
RESULTS
Our data indicated that the late H. pylori eradication therapy group had a higher rate of complicated recurrent peptic ulcers (hazard ratio [HR], 1.52; p=0.006), with time lags of more than 120 days. However, our results indicated a similar risk of complicated recurrent peptic ulcers (HR, 1.20; p=0.275) in time lags of more than 1 year and (HR, 1.10; p=0.621) more than 2 years.
CONCLUSIONS
H. pylori eradication within 120 days was associated with decreased complicated recurrent peptic ulcers in patients with PUB. We recommend that H. pylori eradication should be conducted within 120 days in patients with PUB.

Keyword

Helicobacter pylori; Peptic ulcer hemorrhage; Delayed; Eradication

MeSH Terms

Adult
Aged
Female
Helicobacter Infections/*drug therapy
*Helicobacter pylori
Humans
Male
Middle Aged
Patient Readmission/*statistics & numerical data
Peptic Ulcer/complications/*epidemiology/microbiology
Peptic Ulcer Hemorrhage/complications
Proportional Hazards Models
Recurrence
Time-to-Treatment/*statistics & numerical data
Treatment Outcome
Young Adult
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