Kuang-Wei Huang1, Yi-Chun Kuan2, Nai-Fang Chi3, Yao-Hsien Huang3, Jiing-Chyuan Luo4, Li-Nien Chien5. 1. Division of Gastroenterology, Department of Internal Medicine, Taipei Beitou Health Management Hospital, Taipei, Taiwan; Division of Gastroenterology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan. 2. Department of Neurology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan; Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan. 3. Department of Neurology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan; Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. 4. Division of Gastroenterology, Department of Internal Medicine, Taipei, Veterans General Hospital, Taipei, Taiwan. 5. School of Health Care Administration, College of Management, Taipei Medical University, Taipei, Taiwan. Electronic address: lnchien@tmu.edu.tw.
Abstract
BACKGROUND: The association between chronic obstructive pulmonary disease (COPD) and the risk of recurrent peptic ulcer bleeding (PUB) remains unclear. In this study, we compared the risk of recurrent PUB between patients with and those without COPD. METHODS: Using the Taiwan National Health Insurance Research Database, we first selected patients newly diagnosed with PUB in 2002-2009. Two groups comprising 13,732 COPD cases and 13,732 non-COPD matched controls were created using propensity score matching, thereby making the differences in basic demographics, medication use, and disease conditions between the two groups negligible. Cox proportional hazard regression was used to evaluate the risk of recurrent PUB during the follow-up period. RESULTS: The cumulative recurrence rate of PUB was significantly higher in the patients with COPD than in the non-COPD matched controls (2years: 10.8% vs 9.3%; 6years: 18.3% vs 15.7%, P all <0.05), with an adjusted hazard ratio (HR) of 1.17 (95% confidence interval [CI], 1.08-1.26, P<0.001) and 1.19 (95% CI, 1.12-1.26, P<0.001) within 2-year and 6-year follow-ups, respectively. Patients with COPD using steroids were at a marginally higher risk of recurrent PUB than those who did not use steroids. Multivariate stratified analysis revealed similar results in many subgroups. CONCLUSIONS: The risk of recurrent PUB is higher in patients with COPD than in patients without COPD.
BACKGROUND: The association between chronic obstructive pulmonary disease (COPD) and the risk of recurrent peptic ulcer bleeding (PUB) remains unclear. In this study, we compared the risk of recurrent PUB between patients with and those without COPD. METHODS: Using the Taiwan National Health Insurance Research Database, we first selected patients newly diagnosed with PUB in 2002-2009. Two groups comprising 13,732 COPD cases and 13,732 non-COPD matched controls were created using propensity score matching, thereby making the differences in basic demographics, medication use, and disease conditions between the two groups negligible. Cox proportional hazard regression was used to evaluate the risk of recurrent PUB during the follow-up period. RESULTS: The cumulative recurrence rate of PUB was significantly higher in the patients with COPD than in the non-COPD matched controls (2years: 10.8% vs 9.3%; 6years: 18.3% vs 15.7%, P all <0.05), with an adjusted hazard ratio (HR) of 1.17 (95% confidence interval [CI], 1.08-1.26, P<0.001) and 1.19 (95% CI, 1.12-1.26, P<0.001) within 2-year and 6-year follow-ups, respectively. Patients with COPD using steroids were at a marginally higher risk of recurrent PUB than those who did not use steroids. Multivariate stratified analysis revealed similar results in many subgroups. CONCLUSIONS: The risk of recurrent PUB is higher in patients with COPD than in patients without COPD.
Authors: Russell G Buhr; Nicholas J Jackson; Steven M Dubinett; Gerald F Kominski; Carol M Mangione; Michael K Ong Journal: J Hosp Med Date: 2020-02-11 Impact factor: 2.960
Authors: Moisés Rodríguez-Mañero; Estrella López-Pardo; Alberto Cordero; Alberto Ruano-Ravina; José Novo-Platas; María Pereira-Vázquez; Álvaro Martínez-Gómez; Javier García-Seara; Jose-Luis Martínez-Sande; Carlos Peña-Gil; Pilar Mazón; Jose María García-Acuña; Luis Valdés-Cuadrado; José Ramón González-Juanatey Journal: Int J Chron Obstruct Pulmon Dis Date: 2019-02-12