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H. Pylori as a predictor of marginal ulceration: A nationwide analysis
Author(s) -
Schulman Allison R.,
Abougergi Marwan S.,
Thompson Christopher C.
Publication year - 2017
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1002/oby.21759
Subject(s) - medicine , helicobacter pylori , multivariate analysis , incidence (geometry) , logistic regression , multivariate statistics , stepwise regression , cohort , risk factor , surgery , gastroenterology , statistics , physics , mathematics , optics
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.