Allison R Schulman1,2, Marwan S Abougergi3, Christopher C Thompson1,2. 1. Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, Massachusetts, USA. 2. Harvard Medical School, Boston, Massachusetts, USA. 3. Catalyst Medical Consulting, LLC, Baltimore, Maryland, USA.
Abstract
OBJECTIVE: Helicobacter pylori has been implicated as a risk factor for development of marginal ulceration following gastric bypass, although studies have been small and yielded conflicting results. This study sought to determine the relationship between H. pylori infection and development of marginal ulceration following bariatric surgery in a nationwide analysis. METHODS: This was a retrospective cohort study using the 2012 Nationwide Inpatient Sample (NIS) database. Discharges with ICD-9-CM code indicating marginal ulceration and a secondary ICD-9-CM code for bariatric surgery were included. Primary outcome was incidence of marginal ulceration. A stepwise forward selection model was used to build the multivariate logistic regression model based on known risk factors. A P value of 0.05 was considered significant. RESULTS: There were 253,765 patients who met inclusion criteria. Prevalence of marginal ulceration was 3.90%. Of those patients found to have marginal ulceration, 31.20% of patients were H. pylori-positive. Final multivariate regression analysis revealed that H. pylori was the strongest independent predictor of marginal ulceration. CONCLUSIONS: H. pylori is an independent predictor of marginal ulceration using a large national database. Preoperative testing for and eradication of H. pylori prior to bariatric surgery may be an important preventive measure to reduce the incidence of ulcer development.
OBJECTIVE:Helicobacter pylori has been implicated as a risk factor for development of marginal ulceration following gastric bypass, although studies have been small and yielded conflicting results. This study sought to determine the relationship between H. pyloriinfection and development of marginal ulceration following bariatric surgery in a nationwide analysis. METHODS: This was a retrospective cohort study using the 2012 Nationwide Inpatient Sample (NIS) database. Discharges with ICD-9-CM code indicating marginal ulceration and a secondary ICD-9-CM code for bariatric surgery were included. Primary outcome was incidence of marginal ulceration. A stepwise forward selection model was used to build the multivariate logistic regression model based on known risk factors. A P value of 0.05 was considered significant. RESULTS: There were 253,765 patients who met inclusion criteria. Prevalence of marginal ulceration was 3.90%. Of those patients found to have marginal ulceration, 31.20% of patients were H. pylori-positive. Final multivariate regression analysis revealed that H. pylori was the strongest independent predictor of marginal ulceration. CONCLUSIONS:H. pylori is an independent predictor of marginal ulceration using a large national database. Preoperative testing for and eradication of H. pylori prior to bariatric surgery may be an important preventive measure to reduce the incidence of ulcer development.
Authors: Valentin Mocanu; Jerry T Dang; Noah Switzer; Daniel Skubleny; Xinzhe Shi; Chris de Gara; Daniel W Birch; Shahzeer Karmali Journal: Obes Surg Date: 2018-02 Impact factor: 4.129
Authors: Nicola Di Lorenzo; Stavros A Antoniou; Rachel L Batterham; Luca Busetto; Daniela Godoroja; Angelo Iossa; Francesco M Carrano; Ferdinando Agresta; Isaias Alarçon; Carmil Azran; Nicole Bouvy; Carmen Balaguè Ponz; Maura Buza; Catalin Copaescu; Maurizio De Luca; Dror Dicker; Angelo Di Vincenzo; Daniel M Felsenreich; Nader K Francis; Martin Fried; Berta Gonzalo Prats; David Goitein; Jason C G Halford; Jitka Herlesova; Marina Kalogridaki; Hans Ket; Salvador Morales-Conde; Giacomo Piatto; Gerhard Prager; Suzanne Pruijssers; Andrea Pucci; Shlomi Rayman; Eugenia Romano; Sergi Sanchez-Cordero; Ramon Vilallonga; Gianfranco Silecchia Journal: Surg Endosc Date: 2020-04-23 Impact factor: 4.584