Chronic liver disease and 90-day mortality in 21 359 patients following peptic ulcer bleeding - a Nationwide Cohort Study

Abstract

SUMMARY BackgroundBleeding is a serious and frequent complication of peptic ulcer disease. Hepatic dysfunction can cause coagulopathy and increases the risk of peptic ulcer bleeding. However, whether chronic liver disease increases mortality after peptic ulcer bleeding remains unclear.

Survival of patients with cirrhosis and acute peptic ulcer bleeding compared with variceal bleeding using current first‐line therapies

“…(9,11) Mortality rates of up to 15%-20% have been reported in patients with liver cirrhosis bleeding from peptic ulcers. (2,3,15) Such mortality rates are much higher than those observed in patients with PUB who have no comorbidities. (8,9) On the other hand, these mortality rates are comparable to those observed in patients with cirrhosis with AVB using the currently recommended first-line therapy with a combination of vasoactive drugs, endoscopic ligation, and antibiotic prophylaxis.…”

“…In patients with PUB, concurrent comorbidity is currently a major contributor to mortality, and, among such comorbidities, chronic liver disease has a relevant role . Mortality rates of up to 15%‐20% have been reported in patients with liver cirrhosis bleeding from peptic ulcers . Such mortality rates are much higher than those observed in patients with PUB who have no comorbidities .…”

“…Acute upper gastrointestinal bleeding (UGIB) is common in patients with cirrhosis and is associated with substantial morbidity and mortality . Acute variceal bleeding (AVB) is a frequent cause of UGIB in cirrhosis, whereas peptic ulcer bleeding (PUB) is a non‐negligible cause accounting for up to 20%‐30% of cases with UGIB in cirrhosis .…”

Editorial: chronic liver disease and deaths from peptic ulcer bleeding

“…Holland‐Bill et al . provide further evidence supporting this observation . Using the Danish National Registries for patients and prescriptions, they included over 20 000 patients with an index episode of PU bleeding and compared 90‐day mortality in those with or without cirrhosis or noncirrhotic CLD.…”

Editorial: chronic liver disease and deaths from peptic ulcer bleeding – authors’ reply

“…We thank Drs Sigounas and Penman for their interest in our paper on the impact of chronic liver disease on mortality from peptic ulcer bleeding …”