Volume 16, Number 9—September 2010
Research
Trends in Hospitalizations for Peptic Ulcer Disease, United States, 1998–20051
Table 3
Characteristic | 1998 |
2005 |
% Rate change | β-coefficient‡ | |||
---|---|---|---|---|---|---|---|
No. (SE) | Rate† (95% CI) | No. (SE) | Rate† (95% CI) | ||||
Age, y | |||||||
<20 | 1,320 (151) | 1.7 (1.3–2.0) | 1,718 (276) | 2.1 (1.4–2.8) | +24 | 0.040§ | |
20–44 | 14,617 (648) | 14.1 (12.9–15.3) | 10,391 (457) | 9.9 (9.0–10.7) | −30 | −0.436¶ | |
45–64 | 25,287 (955) | 43.4 (40.2–46.6) | 17,923 (724) | 24.6 (22.7–26.6) | −43 | −2.265¶ | |
>65 |
56,593 (1,866) |
163.5 (152.9–174.0) |
27,733 (1,009) |
75.4 (70.0–80.8) |
−54 |
−10.647¶ |
|
Sex | |||||||
M | 47,162 (1,450) | 38.9 (37.2–40.6) | 28,535 (946) | 20.6 (19.6–21.6) | −47 | −1.854¶ | |
F |
50,656 (1,830) |
33.4 (31.7–35.0) |
29,220 (1,078) |
18.0 (17.0–18.9) |
−46 |
−1.909¶ |
|
Race/ethnicity# | |||||||
White | 51,235 (2,353) | 23.2 (21.7–24.7) | 23,735 (1,117) | 10.3 (9.6–11.0) | −56 | −1.649¶ | |
Black | 11,724 (887) | 44.1 (39.7–48.6) | 7,480 (561) | 23.6 (21.1–26.1) | −47 | −1.926¶ | |
Hispanic | 7,305 (839) | 41.8 (34.0–49.6) | 7,075 (720) | 24.5 (21.1–27.9) | −41 | 0.131§ | |
Asian/Pacific Islander |
2,563 (361) |
34.0 (26.2–41.9) |
1,771 (252) |
15.8 (12.0–19.6) |
−54 |
−1.471¶ |
|
Region | |||||||
Northeast | 17,551 (1,588) | 31.4 (27.8–35.1) | 11,285 (681) | 19.3 (17.6–21.0) | −39 | −1.392¶ | |
Midwest | 23,644 (1,430) | 36.9 (33.6–40.2) | 12,116 (722) | 17.9 (16.3–19.5) | −52 | −2.229¶ | |
South | 37,929 (2,100) | 39.3 (36.4–42.1) | 23,603 (1,476) | 21.6 (19.8–23.4) | −45 | −2.193¶ | |
West |
18,699 (1,038) |
33.6 (30.8–36.3) |
10,766 (738) |
16.5 (14.8–18.1) |
−51 |
−1.493¶ |
|
Total | 97,823 (3,156) | 35.9 (34.3–37.5) | 57,770 (1,925) | 19.2 (18.3–20.1) | −47 | −1.884¶ |
*Diagnosis codes 41.86 from the International Classification of Diseases, 9th Revision, Clinical Modification. National estimates were determined by using the Nationwide Inpatient Sample (21). All H. pylori diagnoses are 1 of as many as 15 diagnoses.
†Per 100,000 population.
‡β-coefficient from linear regression analysis, using a weighted least-squares technique, of the annual rate over the years of the study period. The p value corresponds to the test of the null hypothesis that the coefficient for year is zero.
§p≥0.05.
¶p<0.001.
#Race/ethnicity was missing for 26.0% of the patients hospitalized. Data were insufficient for the race/ethnicity category American Indian/Alaska Native.
References
- Sandler RS, Everhart JE, Donowitz M, Adams E, Cronin K, Goodman C, The burden of selected digestive diseases in the United States. Gastroenterology. 2002;122:1500–11. DOIPubMedGoogle Scholar
- Papatheodoridis GV, Sougioultzis S, Archimandritis AJ. Effects of Helicobacter pylori and nonsteroidal anti-inflammatory drugs on peptic ulcer disease: a systematic review. Clin Gastroenterol Hepatol. 2006;4:130–42. DOIPubMedGoogle Scholar
- Marshall BJ, Warren JR. Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet. 1984;1:1311–5. DOIPubMedGoogle Scholar
- Behrman SW. Management of complicated peptic ulcer disease. Arch Surg. 2005;140:201–8. DOIPubMedGoogle Scholar
- Labenz J, Borsch G. Role of Helicobacter pylori eradication in the prevention of peptic ulcer bleeding relapse. Digestion. 1994;55:19–23. DOIPubMedGoogle Scholar
- Ng EK, Lam YH, Sung JJ, Yung MY, To KF, Chan AC, Eradication of Helicobacter pylori prevents recurrence of ulcer after simple closure of duodenal ulcer perforation: randomized controlled trial. Ann Surg. 2000;231:153–8. DOIPubMedGoogle Scholar
- el-Serag HB, Sonnenberg A. Opposing time trends of peptic ulcer and reflux disease. Gut. 1998;43:327–33. DOIPubMedGoogle Scholar
- Lewis JD, Bilker WB, Brensinger C, Farrar JT, Strom BL. Hospitalization and mortality rates from peptic ulcer disease and GI bleeding in the 1990s: relationship to sales of nonsteroidal anti-inflammatory drugs and acid suppression medications. Am J Gastroenterol. 2002;97:2540–9. DOIPubMedGoogle Scholar
- Centers for Disease Control and Prevention. Knowledge about causes of peptic ulcer disease—United States, March–April 1997. MMWR Morb Mortal Wkly Rep. 1997;46:985–7. PubMedGoogle Scholar
- Munnangi S, Sonnenberg A. Time trends of physician visits and treatment patterns of peptic ulcer disease in the United States. Arch Intern Med. 1997;157:1489–94. DOIPubMedGoogle Scholar
- Tytgat GN. Treatment of Helicobacter pylori infection: management of patients with ulcer disease by general practitioners and gastroenterologists. Gut. 1998;43(Suppl 1):S24–6. DOIPubMedGoogle Scholar
- US Department of Health and Human Services. Healthy People 2010, vol. 1, November 2000 [cited 2010 Jul 12]. http://www.healthypeople.gov/Document/tableofcontents.htm#volume1
- Everhart JE, Kruszon-Moran D, Perez-Perez GI, Tralka TS, McQuillan G. Seroprevalence and ethnic differences in Helicobacter pylori infection among adults in the United States. J Infect Dis. 2000;181:1359–63. DOIPubMedGoogle Scholar
- de Martel C, Parsonnet J. Helicobacter pylori infection and gender: a meta-analysis of population-based prevalence surveys. Dig Dis Sci. 2006;51:2292–301. DOIPubMedGoogle Scholar
- Higham J, Kang JY, Majeed A. Recent trends in admissions and mortality due to peptic ulcer in England: increasing frequency of haemorrhage among older subjects. Gut. 2002;50:460–4. DOIPubMedGoogle Scholar
- Kang JY, Elders A, Majeed A, Maxwell JD, Bardhan KD. Recent trends in hospital admissions and mortality rates for peptic ulcer in Scotland 1982–2002. Aliment Pharmacol Ther. 2006;24:65–79. DOIPubMedGoogle Scholar
- Sonnenberg A. Peptic ulcer. In: JE Everhart, editor. Digestive diseases in the United States: epidemiology and impact. Washington: US Government Printing Office; 1994. p. 357–408.
- Sonnenberg A. Time trends of ulcer mortality in Europe. Gastroenterology. 2007;132:2320–7. DOIPubMedGoogle Scholar
- Sonnenberg A. Time trends of ulcer mortality in non-European countries. Am J Gastroenterol. 2007;102:1101–7. DOIPubMedGoogle Scholar
- Post PN, Kuipers EJ, Meijer GA. Declining incidence of peptic ulcer but not of its complications: a nation-wide study in the Netherlands. Aliment Pharmacol Ther. 2006;23:1587–93. DOIPubMedGoogle Scholar
- Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project. Nationwide Inpatient Sample (NIS), 1998–2005 data; 2007 [cited 2010 Jul 12]. http://www.hcup-us.ahrq.gov/nisoverview.jsp
- Steiner C, Elixhauser A, Schnaier J. The healthcare cost and utilization project: an overview. Eff Clin Pract. 2002;5:143–51. PubMedGoogle Scholar
- US Public Health Service and Health Care Financing Administration. International classification of diseases, 9th rev., clinical modification, 6th ed. (CD-ROM). Washington: US Department of Health and Human Services; 2006.
- US Bureau of the Census. Intercensal estimates of the population by age, sex, and race: 1998–2005. Washington: The Bureau; 2006.
- Research Triangle Institute. SUDAAN users manual, release 8.0. Research Triangle Park (NC): The Institute; 2001.
- Agency for Healthcare Research and Quality. Healthcare Cost and Utilization project, Introduction to the HCUP Nationwide Inpatient Sample (NIS), 2005; 2007 [cited 2010 Jul 12]. http://www.hcup-us.ahrq.gov/nisoverview.jsp
- Gillum BS, Graves EJ, Jean L. Trends in hospital utilization: United States, 1988–92. Vital Health Stat 13. 1996;124:1–71. PubMedGoogle Scholar
- Klein RJ, Schoenborn CA. Age adjustment using the 2000 projected U.S. population. Healthy People 2010 Stat Notes 2001 [cited 2010 Jul 12]. http://www.cdc.gov/nchs/products/hp_pubs.htm
- Elashoff JD, Grossman MI. Trends in hospital admissions and death rates for peptic ulcer in the United States from 1970 to 1978. Gastroenterology. 1980;78:280–5.PubMedGoogle Scholar
- Manual D, Cutler A, Goldstein J, Fennerty MB, Brown K. Decreasing prevalence combined with increasing eradication of Helicobacter pylori infection in the United States has not resulted in fewer hospital admissions for peptic ulcer disease–related complications. Aliment Pharmacol Ther. 2007;25:1423–7. DOIPubMedGoogle Scholar
- Kurata JH, Elashoff JD, Haile BM, Honda GD. A reappraisal of time trends in ulcer disease: factors related to changes in ulcer hospitalization and mortality rates. Am J Public Health. 1983;73:1066–72. DOIPubMedGoogle Scholar
- Sonnenberg A. Temporal trends and geographical variations of peptic ulcer disease. Aliment Pharmacol Ther. 1995;9(Suppl 2):3–12. PubMedGoogle Scholar
- Sonnenberg A. Causes underlying the birth-cohort phenomenon of peptic ulcer: analysis of mortality data 1911–2000, England and Wales. Int J Epidemiol. 2006;35:1090–7. DOIPubMedGoogle Scholar
- Kurata JH, Haile BM, Elashoff JD. Sex differences in peptic ulcer disease. Gastroenterology. 1985;88:96–100. PubMedGoogle Scholar
- Kozak LJ. Underreporting of race in the National Hospital Discharge Survey. Adv Data. 1995;:1–12. PubMedGoogle Scholar
- Demma LJ, Holman RC, Sobel J, Yorita KL, Hennessy TW, Paisano EL, Epidemiology of hospitalizations associated with ulcers, gastric cancers, and Helicobacter pylori infection among American Indian and Alaska Native persons. Am J Trop Med Hyg. 2008;78:811–8. PubMedGoogle Scholar
1Presented in part at the Annual Interscience Conference on Antimicrobial Agents and Chemotherapy and Infectious Diseases Society of America; 2008 Oct 28; Washington, DC (abstract number L-4129).
2Current affiliation: University of North Carolina, Chapel Hill, North Carolina, USA.