Comorbidities affect risk of nonvariceal upper gastrointestinal bleeding.

摘要: Background & Aims The incidence of upper gastrointestinal bleeding (GIB) has not been reduced despite the decreasing peptic ulcers, strategies to eradicate Helicobacter pylori infection, and prophylaxis against ulceration from nonsteroidal anti-inflammatory drugs. Other factors might therefore be involved in pathogenesis GIB. Patients with GIB have increasing nongastrointestinal comorbidity, so we investigated whether comorbidity itself increased risk Methods We conducted a matched case-control study using linked primary secondary care data collected England April 1, 1997 through August 31, 2010. older than 15 years nonvariceal (n = 16,355) were 5 controls by age, sex, year, practice 81,636). All available for extracted modeled conditional logistic regression. Adjusted associations defined Charlson Index, then tested sequential population attributable fractions calculated. Results Comorbidity had strong graded association GIB; adjusted odds ratio single was 1.43 (95% confidence interval [CI]: 1.35–1.52) multiple or severe 2.26 CI: 2.14%–2.38%). additional fraction (19.8%; 95% 18.4%–21.2%) considerably larger that any other measured factor, including aspirin drug use (3.0% 3.1%, respectively). Conclusions Nongastrointestinal is an independent factor GIB, contributes greater proportion patients recognized factors. These findings could help assessment potential causes also explain why remains high aging population.