Key result
NSAID intake was strongly associated with upper gastrointestinal bleeding in patients with duodenal ulcers (OR 9.8; 95% CI 5.2-18.4), while H. pylori infection alone did not correlate with bleeding.
Why the study?
What is the prevalence of H. pylori infection in bleeding duodenal ulcers, and what is the role of NSAID use?
Case-Control (n=520)
What is the prevalence of H. pylori infection in bleeding duodenal ulcers, and what is the role of NSAID use?
Odds Ratio: 9.8 (95% CI 5.2–18.4)
Absolute Event Rate: 34% vs 5.6%
p-value: p=<0.001
In patients with bleeding duodenal ulcers, H. pylori-negative cases are strongly associated with NSAID use; when NSAID users are excluded, H. pylori prevalence is nearly 100%.
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H. pylori testing warranted in bleeding DU irrespective of NSAID use; challenges prior low-prevalence reports but leaves optimal strategies open.
Gisbert et al. (2001) conducted a case-control in Bleeding duodenal ulcer (n=520). NSAID intake vs. No NSAID intake was evaluated on Upper gastrointestinal bleeding (UGIB) (OR 9.8, 95% CI 5.2-18.4, p=<0.001). NSAID intake was strongly associated with upper gastrointestinal bleeding in patients with duodenal ulcers (OR 9.8; 95% CI 5.2-18.4), while H. pylori infection alone did not correlate with bleeding.
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