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Early H elicobacter pylori eradication is associated with a reduced risk of recurrent peptic ulcers in cirrhotic patients
Author(s) -
Chang ShenShong,
Hu HsiaoYun
Publication year - 2014
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/1751-2980.12159
Subject(s) - medicine , peptic , helicobacter pylori , gastroenterology , hazard ratio , cirrhosis , peptic ulcer , confidence interval
Obiective The study aimed to investigate whether early Helicobacter pylori ( H. pylori) eradication therapy in cirrhotic patients caused a dramatic reduction of recurrent peptic ulcers compared with those treated with a late eradication. Methods We identified cirrhotic patients using the International C lassifications of D iseases, R evision 9 ( ICD ‐9‐ CM ). Decompensated cirrhotic patients can apply for a catastrophic illness card and were identified via the ICD ‐9‐ CM codes 571.2, 571.5 and 571.6. Compensated cirrhotic patients were identified via the ICD ‐9‐ CM codes 571.2, 571.5 and 571.6, after excluded decompensated cirrhotic patients. We categorized patients into early (time lag ≤365 days after peptic ulcer diagnosis) and late (time lag >365 days) H . pylori eradication therapy groups. The end‐point was the occurrence of recurrent peptic ulcers. C ox proportional hazards model was used to calculate the hazard ratios ( HR s). Results Altogether, 154 cirrhotic patients were included in the early H . pylori eradication group and 103 in the late H . pylori eradication group. Cirrhotic patients had a higher risk of recurrent peptic ulcers in the late H . pylori eradication group (HR 1.58, 95% CI 1.09–2.28, P = 0.015). However, the risk of recurrent peptic ulcers in alcoholic cirrhotic patients in both groups ( HR 1.47, 95% CI 0.77–2.83, P = 0.247) was similar. Conclusions Early H . pylori eradication is associated with a lower risk of recurrent peptic ulcers in cirrhotic patients. H . pylori eradication is the mainstay for treating cirrhotic patients who have contracted peptic ulcers.