L-4129. Recent Trends in Peptic Ulcer Disease Hospitalizations, United States, 1998-2005
Session: Poster Session: Gastrointestinal Infections: Food for Thought
Tuesday, October 28, 2008: 12:00 AM
Room: Hall C
Background: Infection with H. pylori increases the risk for peptic ulcer disease (PUD) and its complications. Antibiotic regimens to eradicate H. pylori and cure ulcers have been used since the 1980s. We determined if PUD hospital admission rates have declined in the era of eradication therapy.
Methods: Hospitalization records with a primary discharge diagnosis of PUD, defined as duodenal ulcer, gastric ulcer, peptic ulcer, or gastro-jejunal ulcer, during 1998-2005 were reviewed using the Nationwide Inpatient Sample (NIS). The NIS is a 20% sample of US hospitalizations from short-term, nonfederal, general and specialty hospitals. National estimates were calculated using discharge weights developed by the Healthcare Cost and Utilization Project. Hospitalization rates were examined by age group (<20, 20-44, 45-64, and ≥65 years), sex, and race. Results: The annual PUD hospitalization rate decreased 18% from 70.2 (95% confidence interval [CI] 67.3-73.0) per 100,000 in 1998 to 57.3 (95% CI 54.7-59.9) per 100,000 in 2005. In 2005, 169,858 (standard error=3889) PUD hospitalizations occurred in the United States and adults ≥44 years of age accounted for 86% of cases. PUD hospitalization rates decreased for all age groups ≥20 years (insufficient data for persons <20) and declined more rapidly among men (22%) than women (15%). A decline in PUD hospitalization rates was noted for all races except for American Indian/Alaskan Natives (AI/AN), and the greatest decline was observed among Blacks (36%). Conclusions:
Annual PUD hospitalization rates declined during 1998-2005 for adults, both sexes, and all races except AI/AN. These findings suggest that the incidence of complications due to H. pylori infection has markedly declined. Further declines in PUD hospitalizations will require continued education of patients and health care providers about the association between H. pylori and PUD. Studies are needed to determine why PUD hospitalizations have not decreased equally for all groups.
Claudia Steiner, Agency for Healthcare Research and Quality, David Swerdlow, MD, CDC, Krista Yorita, MPH, Centers for Disease Control and Prevention, Atlanta, GA, Lydia Feinstein, CDC, Decatur, GA, Robert Holman, MS, CDC, Atlanta, GA and  L. Feinstein, None.