What question did this study set out to answer?

To determine whether Helicobacter pylori infection influences the risk of upper gastrointestinal bleeding in patients taking aspirin.

July 26, 2010Alimentary Pharmacology & TherapeuticsOpen Access

Systematic review: Helicobacter pylori and the risk of upper gastrointestinal bleeding risk in patients taking aspirin

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Why the study?

Does Helicobacter pylori infection increase upper gastrointestinal bleeding risk in adults taking aspirin?

Population

Adults taking aspirin and presenting with upper gastrointestinal bleeding

Comparison

Helicobacter pylori infection vs Absence of Helicobacter pylori infection

Design

Systematic_review

Authors

EFEmma FletcherCouncil of Graduate Schools DJDavid JohnstonNorthside Hospital CFC. R. FisherPennsylvania State University

Discussion

Member takes

Implication

Challenges assumption that H. pylori raises UGIB risk with aspirin; insufficient data leave the question open for prospective study.

Key Points

To determine whether Helicobacter pylori infection influences the risk of upper gastrointestinal bleeding in patients taking aspirin.
Searched MEDLINE and EMBASE databases for studies reporting Helicobacter pylori status in adults taking aspirin who developed upper gastrointestinal bleeding.
Identified and analyzed 13 studies, comprising one case-control study, 10 cohort studies, and two randomized controlled trials.
The single case-control study (n = 245) identified Helicobacter pylori as a significant independent risk factor for upper gastrointestinal bleeding.
Across 10 cohort studies totaling 5,465 patients, study designs were highly heterogeneous and only 163 aspirin users with upper gastrointestinal bleeding were tested for the infection.
Two randomized controlled trials reported no statistically significant effects, leaving data insufficient to perform a formal meta-analysis.

Structured PICO

Does Helicobacter pylori infection increase upper gastrointestinal bleeding risk in adults taking aspirin?

Population

Adults taking aspirin and presenting with upper gastrointestinal bleeding (13 studies: 1 case-control, 10 cohort studies, 2 RCTs)

Intervention

Helicobacter pylori infection

Comparator

Absence of Helicobacter pylori infection

Outcome

Upper gastrointestinal bleeding risksafety

There is insufficient evidence to support the widely held belief that H. pylori infection increases the risk of upper gastrointestinal bleeding in patients taking aspirin.

Limitations

Heterogeneous cohort studies varying in inclusion criteria, doses and duration of aspirin used, mode of H. pylori testing and causative GI pathology
Very limited evidence available
Data not sufficient to allow meta-analyses

Cite This Study

Fletcher et al. (2010) studied this question.

synapsesocial.com/papers/6a7163b58031ec7bb1dcf18c https://doi.org/10.1111/j.1365-2036.2010.04415.x

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Systematic review: Helicobacter pylori and the risk of upper gastrointestinal bleeding risk in patients taking aspirin

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Systematic review: Helicobacter pylori and the risk of upper gastrointestinal bleeding risk in patients taking aspirin

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider