Original Contribution
The American Journal of Gastroenterology (2006) 101, 945–953; doi:10.1111/j.1572-0241.2006.00518.x
Complicated and Uncomplicated Peptic Ulcers in a Danish County 1993–2002: A Population-Based Cohort Study
Annmarie Lassen PhD1, Jesper Hallas DMS2 and Ove BSchaffalitzky de Muckadell DMS1
- 1Department of Medical Gastroenterology, Odense University Hospital, 5000 Odense C, Denmark
- 2Institute of Clinical Pharmacology, University of Southern Denmark, Odense, Denmark
Correspondence: Annmarie Lassen, PhD, Department of Medical Gastroenterology, Odense University Hospital, 5000 Odense C, Denmark.
Received 9 September 2005; Accepted 6 December 2005.
Abstract
Peptic ulcer epidemiology changes as the proportion of Helicobacter pylori infected people decreases, use of nonsteroidal anti-inflammatory drugs (NSAID) increases, and the proportion of elderly persons increases.
OBJECTIVES:
To describe incidence and prognosis of uncomplicated and complicated peptic ulcer patients in Funen County 1993–2002.
METHODS:
Data on endoscopies, gastric and duodenal operations, and related peptic ulcer diagnoses were extracted from four population-based databases covering a period from 1974 to 2002. All citizens of Funen County (population 470,000) who between 1993 and 2002 had a peptic ulcer diagnosed for the first time were identified.
RESULTS:
Between 1993 and 2002 the incidence of uncomplicated duodenal ulcer decreased from 0.55/1,000 person-years (95% CI 0.49–0.62) to 0.37 (0.31–0.43), uncomplicated gastric ulcer decreased from 0.56 (0.49–0.63) to 0.40 (0.34–0.46), and perforated ulcer decreased from 0.14 (0.11–0.18) to 0.08 (0.06–0.11). The incidence of bleeding peptic ulcer was stable with 0.55 (0.49–0.62) in 1993 and 0.57 (0.51–0.64) in 2002. The proportion of possible NSAID-related incident peptic ulcers increased from 320/827 (39%) in 1993 to 363/686 (53%) in 2002 (p < 0.01). A total of 3,233 patients with incident complicated peptic ulcer (9,927 person-years) and 4,421 patients with incident uncomplicated peptic ulcer (17,773 person-years) was followed for up to 10 yr. The first month following newly diagnosed complicated ulcer the standardized mortality rate was 37.1 (33.4–41.1) during the next 11 months it was 5.1 (4.6–5.6), and in the following years it was 2.6 (2.4–2.8). The corresponding figures for incident uncomplicated peptic ulcer was 11.6 (9.6–13.9), 4.0 (3.6–4.4), and 2.5 (2.3–2.7).
CONCLUSION:
During the period, incidence of peptic ulcers decreased and an increasing proportion was related to NSAID. Mortality is high.
