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Optimal initiation of Helicobacter pylori eradication in patients with peptic ulcer bleeding.

Abstract：

AIM:To evaluate when Helicobacter pylori (H. pylori) eradication therapy (ET) should be started in patients with peptic ulcer bleeding (PUB). METHODS:Clinical data concerning adults hospitalized with PUB were retrospectively collected and analyzed. Age, sex, type and stage of peptic ulcer, whether endoscopic therapy was performed or not, methods of H. pylori detection, duration of hospitalization, and specialty of the attending physician were investigated. Factors influencing the confirmation of H. pylori infection prior to discharge were determined using multiple logistic regression analysis. The H. pylori eradication rates of patients who received ET during hospitalization and those who commenced ET as outpatients were compared. RESULTS:A total of 232 patients with PUB were evaluated for H. pylori infection by histology and/or rapid urease testing. Of these patients, 53.7% (127/232) had confirmed results of H. pylori infection prior to discharge. In multivariate analysis, duration of hospitalization and ulcer stage were factors independently influencing whether H. pylori infection was confirmed before or after discharge. Among the patients discharged before confirmation of H. pylori infection, 13.3% (14/105) were lost to follow-up. Among the patients found to be H. pylori-positive after discharge, 41.4% (12/29) did not receive ET. There was no significant difference in the H. pylori eradication rate between patients who received ET during hospitalization and those who commenced ET as outpatients [intention-to-treat: 68.8% (53/77) vs 60% (12/20), P=0.594; per-protocol: 82.8% (53/64) vs 80% (12/15), P=0.723]. CONCLUSION:Because many patients with PUB who were discharged before H. pylori infection status was confirmed lost an opportunity to receive ET, we should confirm H. pylori infection and start ET prior to discharge.

journal_name

World J Gastroenterol

journal_title

World journal of gastroenterology

authors

Yoon H,Lee DH,Jang ES,Kim J,Shin CM,Park YS,Hwang JH,Kim JW,Jeong SH,Kim N

doi

10.3748/wjg.v21.i8.2497

subject

Has Abstract

pub_date

2015-02-28 00:00:00

pages

2497-503

issue

eissn

1007-9327

issn

2219-2840

journal_volume

pub_type

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Optimal initiation of Helicobacter pylori eradication in patients with peptic ulcer bleeding.