Absence of Helicobacter pylori is not protective against peptic ulcer bleeding in elderly on offending agents: lessons from an exceptionally low prevalence population

作者：Lee Yeong Yeh^*; Noridah Nordin; Hassan Syed Abdul Aziz Syed; Menon Jayaram

来源：PeerJ, 2014, 2: e257.

DOI：10.7717/peerj.257

• Elderly
• Helicobacter pylori
• Malays
• Peptic ulcer
• Upper gastrointestinal bleeding

Aim. Helicobacter pylori (H. pylori) infection is exceptionally rare in population from the north-eastern region of Peninsular Malaysia. This provides us an opportunity to contemplate the future without H. pylori in acute non-variceal upper gastrointestinal (Cl) bleeding. %26lt;br%26gt;Methods. All cases in the GI registry with GI bleeding between 2003 and 2006 were reviewed. Cases with confirmed non-variceal aetiology were analysed. Rockall score %26gt; 5 was considered high risk for bleeding and primary outcomes studied were in hospital mortality, recurrent bleeding and need fir surgery. %26lt;br%26gt;Results. The incidence of non-variceal upper GI bleeding was 2.2/100,000 person years. Peptic ulcer bleeding was the most common aetiology (1.8/100,000 person years). In-hospital mortality (3.6%), recurrent bleeding (9.6%) and need for surgery (4.0%) were uncommon in this population with a largely low risk score (85.2% with score %26lt;= 5). Elderly were at greater risk for bleeding (mean 68.5 years, P = 0.01) especially in the presence of duodenal ulcers (P = 0.04) despite gastric ulcers being more common. NSAIDs, aspirin and co-morbidities were the main risk factors. %26lt;br%26gt;Conclusions. The absence of H. pylori infection may not reduce the risk of peptic ulcer bleeding in the presence of risk factors especially offending drugs in the elderly.

• 出版日期2014-2-11