Patients with Peptic Ulcer Bleeding and Hepatic, Renal, or Malignant Comorbidities Face Increased Risk of Death

Researchers from the Division of Gastroenterology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada, recently reported that certain classes of comorbidities increase mortality risk in patients with peptic ulcer bleeding, but the presence of any comorbidities also affects mortality risk.

In “Effect of Comorbidity on Mortality in Patients With Peptic Ulcer Bleeding: Systematic Review and Meta-Analysis,” published in The American Journal of Gastroenterology, researchers analyzed data from 16 studies of patients with peptic ulcer bleeding and other diseases or conditions published in PubMed and Embase between January 19989 and January 2010. They reported that only three studies had a low risk of bias, and that “the overall quality of evidence was low.”

They assessed the impact of comorbidity on short-term mortality in patients with peptic ulcer bleeding and found that 30-day mortality and in-hospital mortality risk was significantly greater in patients with peptic ulcer bleeding and at least one comorbidity than in those without any complicating comorbid conditions.

In the study, patients with peptic ulcer disease who had three or more comorbidities were found to have a greater risk of dying than patients who only presented with one or two comorbidities. However, the authors reported that “All individual comorbidities that we assessed significantly increased the risk of death” associated with peptic ulcer bleeding,” with high relative risks for hepatic, renal, and malignant disease than for cardiovascular and respiratory disease and diabetes.

Based on these findings, the authors concluded that “Underlying comorbidity is consistently associated with increased mortality in patients with [peptic ulcer bleeding]. The number and type of comorbidities in patients with [peptic ulcer bleeding] should be carefully evaluated and factored into initial management strategies.”