Seasonal and Geographic Variation in Peptic Ulcer Disease and Associated Complications in the United States of America

IF 1.4 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Journal of research in health sciences Pub Date : 2023-12-29 DOI:10.34172/jrhs.2023.130
Kausthubha Yaratha, Lindsay Talemal, Brian V Monahan, Daohai Yu, Xiaoning Lu, Juan Lucas Poggio
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Abstract

Background: Hospitalization for peptic ulcer disease (PUD) has been described outside of North America as peaking in the fall and winter. However, no recent literature has so far investigated the seasonal fluctuations and complications of PUD in the USA. Study Design: Cross-sectional population database review. Methods: Patients with a diagnosis of either acute gastric or acute duodenal ulcers from January 1, 2015, through December 31, 2017, were identified in the Healthcare Cost and Utilization Project’s National Inpatient Sample. The proportion of admissions with either hemorrhage or perforation was determined for each season and further subdivided into geographic regions. Results: Of 18829 hospitalizations for PUD, admissions were the highest in the fall (25.9%) while being the lowest in the summer (23.9%). Complications, hemorrhage or perforation, were the highest and the lowest in the fall and spring, respectively (75.7% vs. 73.6%; P=0.060 for comparing all 4 seasons). Geographically, the West had the highest rate of peptic ulcer hemorrhage (64.5%, P=0.004), while the northeast had the highest rate of perforation (14.3%, P=0.003). Hemorrhage was more common in males, those who used aspirin, nonsteroidal anti-inflammatory drugs, or anticoagulants, and diabetics (P<0.05). Perforation was less common in males, those with diabetes, obesity, or hypertension (HTN), or those using aspirin or anticoagulants (P<0.05). Helicobacter pylori infection was more associated with perforation in the fall and winter months. Conclusion: Seasonal and regional trends in hospitalizations due to PUD may help identify modifiable risk factors, which can improve diagnostic and treatment outcomes for patients by allowing for more targeted identification of vulnerable populations.
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美国消化性溃疡疾病及相关并发症的季节和地域差异
背景:在北美以外的地区,消化性溃疡病(PUD)的住院治疗高峰期在秋冬季节。然而,迄今为止还没有最新文献对美国消化性溃疡病的季节性波动和并发症进行调查。研究设计:横断面人群数据库回顾。研究方法从医疗保健成本与利用项目的全国住院患者样本中识别出 2015 年 1 月 1 日至 2017 年 12 月 31 日期间诊断为急性胃溃疡或急性十二指肠溃疡的患者。确定了每个季节发生出血或穿孔的入院比例,并按地理区域进一步细分。结果:在 18829 例 PUD 住院病例中,秋季入院率最高(25.9%),夏季最低(23.9%)。并发症(出血或穿孔)在秋季和春季分别最高和最低(75.7% 对 73.6%;四季比较 P=0.060)。从地域上看,西部地区消化性溃疡出血率最高(64.5%,P=0.004),而东北部地区穿孔率最高(14.3%,P=0.003)。出血在男性、使用阿司匹林、非甾体抗炎药或抗凝剂的人群以及糖尿病患者中更为常见(P<0.05)。穿孔在男性、糖尿病、肥胖或高血压(HTN)患者、使用阿司匹林或抗凝剂的患者中较少见(P<0.05)。幽门螺杆菌感染与秋冬季节的穿孔关系更大。结论幽门螺杆菌感染与穿孔的相关性在秋冬季节更高。幽门螺杆菌感染的季节性和地区性趋势有助于确定可改变的风险因素,从而更有针对性地识别易感人群,改善患者的诊断和治疗效果。
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来源期刊
Journal of research in health sciences
Journal of research in health sciences PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
2.30
自引率
13.30%
发文量
7
期刊介绍: The Journal of Research in Health Sciences (JRHS) is the official journal of the School of Public Health; Hamadan University of Medical Sciences, which is published quarterly. Since 2017, JRHS is published electronically. JRHS is a peer-reviewed, scientific publication which is produced quarterly and is a multidisciplinary journal in the field of public health, publishing contributions from Epidemiology, Biostatistics, Public Health, Occupational Health, Environmental Health, Health Education, and Preventive and Social Medicine. We do not publish clinical trials, nursing studies, animal studies, qualitative studies, nutritional studies, health insurance, and hospital management. In addition, we do not publish the results of laboratory and chemical studies in the field of ergonomics, occupational health, and environmental health
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