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>Journals >Revista Médica del Instituto Mexicano del Seguro Social >Year 2009, Issue 2

Rodríguez-Hernández H, Rodríguez-Morán M, González JL, Jáquez-Quintana JO, Rodríguez-Acosta ED, Sosa-Tinoco E, Guerrero-Romero F
Risk Factors Associated with Upper Gastrointestinal Bleeding and with Mortality
Rev Med Inst Mex Seguro Soc 2009; 47 (2)

Language: Español
References: 35
Page: 179-184
PDF: 39.28 Kb.

Full text


Objective: to determine the associated risk factors with upper gastrointestinal bleeding (UGIB) and mortality in subjects with peptic ulcer.
Methods: a total of 345 subjects with peptic ulcer, ‹ 60 years of age, were enrolled in a cross-sectional study. Subjects were allocated into one of two groups in accordance with the presence of UGIB. A logistic regression model, adjusted by age and sex, was used to compute the relationship between the risk factors and both UGIB and mortality.
Results: smoking (OR = 2.6, CI 95 % = 1.2-8.7), alcohol consumption (OR = 4.8, CI 95 % = 1.4-10.5), and previous history of UGIB (OR = 1.8, CI 95 % = 1.1-9.7) were strongly and independently associated with UGIB; chronic obstructive pulmonary disease (OR = 1.9, CI 95 % = 1.2-11.4), and high blood pressure (OR = 1.4, CI 95 % = 1.1- 7.5) were associated with mortality in UGIB.
Conclusions: the associated risk factors with UGIB in patients with peptic ulcer were: age lower than 60 years; smoking; history of UGIB; and alcohol consumption. The chronic obstructive pulmonary disease and high blood pressure were associated with mortality in UGIB.

Key words: gastrointestinal hemorrhage, peptic ulcer, Helicobacter pylori, pulmonary disease, chronic obstructive, hypertension.


  1. Laine L, Peterson WL. Bleeding peptic ulcer. N Engl J Med 1994;331(11):717-727.

  2. Loperfido S, Monica F, Maifreni ML, Paccagnella A, Fama R, Dal Pos R, et al. Bleeding peptic ulcer occurring in hospitalized patients: analysis of predictive and risk factors comparison with outof-hospital onset of hemorrhage. Dig Dis Sci 1994;39(4):698-705.

  3. Farrell JJ, Friedman LS. Gastrointestinal bleeding in older people. Gastroenterol Clin North Am 2000;29(1):1-36.

  4. Silverstein FE, Gilbert DA, Tedesco FJ, Buenger NK, Persing J. The national ASGE survey on upper gastrointestinal bleeding: II. Clinical prognostic factors. Gastrointest Endosc 1981;27(2): 80-93.

  5. Henry D, Dobson A, Turner C. Variability in the risk of major gastrointestinal complications from nonaspirin nonsteroidal anti-inflammatory drugs. Gastroenterology 1993;105(4):1078-1088.

  6. Rodríguez-Hernández H, Jacobo-Karam JS, Jáquez-Quintana JO, Ávila-Romero HG, Galván- Román L, Lara-Miranda S, et al. Gastropatía por antiinflamatorios no esteroideos y su asociación con Helicobacter pylori. Rev Invest Clin 2003; 55(3):254-259.

  7. Capell MS, Nadler SC. Increased mortality of acute upper gastrointestinal bleeding in-patients with chronic obstructive pulmonary disease: a case controlled multiyear study of 53 consecutive patients. Dig Dis Sci 1995;40(2):256-262.

  8. Kubba AK, Choudari C, Rajgopal C, Ghosh S, Palmer KR. Reduced long-term survival following major peptic ulcer haemorrhage. Br J Surg 1997; 84:265-268.

  9. Friedman LS, Martin P. The problem of gastrointestinal bleeding. Gastroenterol Clin North Am 1993;22(4):717-721.

  10. Laine L, Hopokins RJ, Girardi LS. Has the impact of Helicobacter pylori therapy on ulcer recurrence in the United States been overstated? A meta-analysis of rigorously designed trials. Am J Gastroenterol 1998;93(9):1409-1415.

  11. Jyotheeswaran S, Shah AN, Jin HO, Potter GD, Ona FV, Chey WY. Prevalence of Helicobacter pylori in peptic ulcer patients in greater Rochester, NY: is empirical triple therapy justified? Am J Gastroenterol 1998;93(4):574-578.

  12. Ciociola AA, McSorley DJ, Turner K, Sykes D, Palmer JB. Helicobacter pylori infection rates in duodenal ulcer patients in the United Status may be lower that previously estimated. Am J Gastroenterol 1999;94(7):1834-1840.

  13. Miwa H, Sakaki N, Sugano K, Sekine H, Higuchi K, Uemura N, et al. Recurrent peptic ulcers in patients following successful Helicobacter pylori eradication: a multicenter study of 4940 patients. Helicobacter 2004;9(1):9-16.

  14. Larson G, Schmidt T, Gott J, Ond S, O’Connor CA, Richardson JD. Upper gastrointestinal bleeding: Predictors of outcome. Surgery 1986;100 (4):765-773.

  15. National Institutes of Health. The sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Arch Intern Med 1997;157(21):2413-2446.

  16. Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 2000;23 (Suppl 1):S4-S19.

  17. Bobadilla J, Vargas-Vorácková F, Gómez A, Villalobos JJ. Frecuencia de la úlcera péptica en el Instituto Nacional de la Nutrición “Salvador Zubirán”. Estudio de localización, factores asociados y tendencias temporales. Rev Gastroenterol Mex 1996;61(1):31-35.

  18. Depolo A, Dobrila-Dintinjana R, Uravi M, Grbas H, Rubini M. Upper gastrointestinal bleeding: review of our ten years results. Zentralbl Chir 2001;126(10):772-776.

  19. Lassen A, Hallas J, Schaffalitzky de Muckadell OB. Complicated an uncomplicated peptic ulcers in a Danish County 1993-2002: A population- Based cohort study. Am J Gastroenterol 2006; 101(5):945-953.

  20. Villalobos JJ, Menéndez V, Tanimoto M, Guerrero A. Úlcera péptica en el Hospital de Enfermedades de la Nutrición. Rev Invest Clin 1960;12(3- 4):429-448.

  21. Rodríguez-Hernández H, Jacobo-Karam JS, Guerrero-Romero F. Factores de riesgo para a recurrencia de úlcera péptica. Gac Med Mex 2001; 137(4):303-310.

  22. Chan FK, Leung WK. Peptic ulcer disease. Lancet 2002;360(9337):933-941.

  23. García MP, Mart E, Villalobos JJ. Epidemiología de la úlcera péptica en el Instituto Nacional de la Nutrición. Rev Invest Clin 1981;33(2):165-168.

  24. Villalobos-Pérez JJ, Quiñones-Menéndez NF, Cruz-Lomelí G, Vargas-Vorackova F. Epidemiología de la úlcera péptica en el Instituto Nacional de la Nutrición “Salvador Zubirán”. Rev Gastroenterol Mex 1990;55(2):55-60.

  25. Guzzo JL, Duncan M, Bass BL, Bochicchio GV, Napolitano LM. Severe and refractory peptic ulcer disease: the diagnostic dilema. Dig Dis Sci 2005; 50(11):1999-2008.

  26. Roth SH. From peptic ulcer disease to NSAID gastropathy. An evolving nosology. Drugs Aging 1995;6(5):358-367.

  27. Chan FK, Graham DY. Review article: prevention of non-steroidal anti-inflammatory drug gastrointestinal complications review and recommendations based on risk assessment. Aliment Pharmacol Ther 2004;19(10):1051-1061.

  28. Sung J, Russell RI, Nyeomans, Chan FK, Chen S, Fock K, et al. Non-steroidal anti-inflammatory drug toxicity in the upper gastrointestinal tract. J Gastroenterol Hepatol 2000;15:(Suppl):G58-G68.

  29. Chan FK, Sung JJ, Chung SC, To KF, Yung MY, Leung VK, et al. Randomized trial of eradication of Helicobacter pylori before non-steroidal antiinflammatory drug therapy to prevent peptic ulcers. Lancet 1997;350(9083):975-9779.

  30. Porro GB, Parente F, Imbesi V. Role of Helicobacter pylori in ulcer healing and recurrence of gastric and duodenal ulcer in long term NSAID users: response to omeprazole dual therapy. Gut 1966;39:22-26.

  31. Di Mario F, Leandro G, Battaglia G, Pilotto A, Del Santo P, Vianello F, et al. Do concomitant diseases and therapies affect the persistence of ulcer symptoms in the elderly? Dig Dis Sci 1996;41 (1):17-21.

  32. Lanas AI, Remacha B, Esteva F. Risk factors associated with refractory peptic ulcers. Gastroenterology 1995;109(4):1124-1132.

  33. Depolo A, Dobrila-Dintinjana R, Uravi M, Grbas H, Rubini M. Upper gastrointestinal bleeding. Review of our ten years results. Zentralbl Chir 2001; 126(10):772-776

  34. Sillakivi T, Lang A, Tein A, Peetsalu A. Evaluation of risk for mortality in surgically treated perforated peptic ulcer. Hepatogastroenterology 2000;47(36): 1765-1768.

  35. Tonus C, Weisenfeld E, Appel P, Nier H. Introduction of proton puma inhibitors—consequences for surgical treatment of peptic ulcer. Hepatogastroenterology 2000;47(31):285-290.

>Journals >Revista Médica del Instituto Mexicano del Seguro Social >Year 2009, Issue 2

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