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Henrik Gammelager

Chronic liver disease and 90-day mortality in 21,359 patients following peptic ulcer bleeding--a Nationwide Cohort Study

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BACKGROUND: Bleeding is a serious and frequent complication of peptic ulcer disease. Hepatic dysfunction can cause coagulopathy and increases the risk of peptic ulcer bleeding. However, whether chronic liver disease increases mortality after peptic ulcer bleeding remains unclear.

AIM: To examine the prognostic impact of chronic liver disease on mortality after peptic ulcer bleeding.

METHODS: We used population-based medical registries to conduct a cohort study of all Danish residents hospitalised with incident peptic ulcer bleeding from 2004 through 2011. We identified patients diagnosed with liver cirrhosis or non-cirrhotic chronic liver disease before their admission for peptic ulcer bleeding. We then computed 90-day mortality after peptic ulcer bleeding based on the Kaplan-Meier method (1 - survival function) and used a Cox regression model to estimate mortality rate ratios (MRRs), controlling for potential confounders.

RESULTS: We identified 21,359 patients hospitalised with peptic ulcer bleeding. Among these, 653 (3.1%) had a previous diagnosis of liver cirrhosis and 474 (2.2%) had a history of non-cirrhotic chronic liver disease. Patients with liver cirrhosis and non-cirrhotic chronic liver disease had a cumulative 90-day mortality of 25.3% and 20.7%, respectively, compared to 18.3% among patients without chronic liver disease. Liver cirrhosis was associated with an adjusted 90-day MRR of 2.38 (95% CI: 2.02-2.80), compared to 1.49 (95% CI: 1.22-1.83) among patients with non-cirrhotic chronic liver disease.

CONCLUSION: Patients with chronic liver disease, particularly liver cirrhosis, are at increased risk of death within 90 days after hospitalisation for peptic ulcer bleeding compared to patients without chronic liver disease.

OriginalsprogEngelsk
TidsskriftAlimentary Pharmacology and Therapeutics
Vol/bind41
Nummer6
Sider (fra-til)564-72
Antal sider9
ISSN0269-2813
DOI
StatusUdgivet - mar. 2015

    Forskningsområder

  • Aged, Aged, 80 and over, Cohort Studies, Female, Hospitalization, Humans, Liver Cirrhosis, Liver Diseases, Male, Middle Aged, Peptic Ulcer, Peptic Ulcer Hemorrhage, Prognosis

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