Factors Associated With Adherence to Helicobacter pylori Testing During Hospitalization for Bleeding Peptic Ulcer Disease

Hung, Kenneth W.; Knotts, Rita M.; Faye, Adam S.; Pont, Adam R.; Lebwohl, Benjamin; Abrams, Julian A.; Freedberg, Daniel E.

doi:10.1016/j.cgh.2019.07.037

Cited by 20 publications

(23 citation statements)

References 18 publications

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“…Retrospective studies in general reveal that testing for H. pylori is not well established in daily practice and often present missing data on H. pylori status [20,33,34].…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal bleeding due to peptic ulcers and erosions – a prospective observational study (BLUE study)

Romstad

Detlie

Søberg

et al. 2020

Scandinavian Journal of Gastroenterology

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Objectives: Acute upper gastrointestinal bleeding is a well-recognized complication of peptic ulcers and erosions. The aim of this study was to assess the incidence rate and identify risk factors for this complication in southeastern Norway. Materials and methods: Between March 2015 and December 2017, a prospective observational study was conducted at two Norwegian hospitals with a total catchment area of approximately 800,000 inhabitants. Information regarding patient characteristics, comorbidities, drug use, H. pylori status and 30-day mortality was recorded. Results: A total of 543 adult patients were included. The incidence was 30/100,000 inhabitants per year. Altogether, 434 (80%) of the study patients used risk medication. Only 46 patients (8.5%) used proton pump inhibitors (PPIs) for more than 2 weeks before the bleeding episode. H. pylori testing was performed in 527 (97%) patients, of whom 195 (37%) were H. pylori-positive. The main comorbidity was cardiovascular disease. Gastric and duodenal ulcers were found in 183 (34%) and 275 (51%) patients, respectively. Simultaneous ulcerations at both locations were present in 58 (10%) patients, and 27 (5%) had only erosions. Overall, the 30-day mortality rate was 7.6%. Conclusions: The incidence of upper gastrointestinal bleeding due to peptic ulcers and erosions was found to be lower than previously demonstrated in comparable studies, but the overall mortality rate was unchanged. The consumption of risk medication was high, and only a few patients had used prophylactic PPIs. Concurrent H. pylori infection was present in only one-third of the patients. Clinical trial registration: Bleeding Ulcer and Erosions Study 'BLUE Study', ClinicalTrials.gov Identifier. NCT03367897.

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“…Retrospective studies in general reveal that testing for H. pylori is not well established in daily practice and often present missing data on H. pylori status [20,33,34].…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal bleeding due to peptic ulcers and erosions – a prospective observational study (BLUE study)

Romstad

Detlie

Søberg

et al. 2020

Scandinavian Journal of Gastroenterology

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“…3 In a recent study by Hung et al, 81% of inpatients presenting with upper GI bleeding due to PUD were tested for H pylori, an improvement from <60% historically, but still disappointingly low. 4 We similarly reviewed inpatient consults for GI bleeding at the Michael E. DeBakey VA Medical Center in Houston, Texas from December 2017 to February 2018 and found 19 patients with PUD of whom only 13 (68%) were tested for H pylori, providing an important opportunity for improvement. AIMS: We aimed to increase testing for H pylori in patients who present with acute upper GI bleeding due to PUD from our baseline of 68% to 90% over the course of 6 months.…”

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confidence: 99%

HP QI Abstract: Improving Helicobacter pylori Testing in Patients With Acute Upper GI Bleeding Due to Peptic Ulcer Disease

Bernica¹,

Cole²,

Flores³

et al. 2020

Gastroenterology

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“…6 Furthermore, antibiotic resistance is increasing 7 and knowledge of resistance patterns is seldom available. 8 In this context, the recent article by Hung et al 9 in this issue of Clinical Gastroenterology and Hepatology is particularly relevant. They have performed a thorough investigation of factors associated with the failure to test for the presence of H pylori in patients admitted with GI bleeding in the setting of PUD.…”

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confidence: 99%

“…Once again, Hung et al 9 provide meaningful perspective to their findings, having assessed the clinical consequences of failure to test. Within their cohort, repeat bleeding or death occurred more than twice as often in patients who were never tested compared with those who were.…”

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confidence: 99%

“…As others have shown, gastroenterologists have awareness of optimal treatment approaches for PUD, 12 and gastroenterologist involvement results in improved guideline adherence relative to other specialities. 6 Although disappointing, in many ways the data from Hung et al 9 highlight an opportunity for improvement. Particularly because the management of H pylori-associated PUD represents a continuous episode of care, (an algorithmic approach jointly undertaken and shared by gastroenterologists), inpatient teams and outpatient practitioners is critical for improving quality.…”

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confidence: 99%

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Increasing Testing for Helicobacter pylori Infection to Improve Quality of Patient Care

Leiman

2020

Clinical Gastroenterology and Hepatology

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Factors Associated With Adherence to Helicobacter pylori Testing During Hospitalization for Bleeding Peptic Ulcer Disease

Cited by 20 publications

References 18 publications

Gastrointestinal bleeding due to peptic ulcers and erosions – a prospective observational study (BLUE study)

Gastrointestinal bleeding due to peptic ulcers and erosions – a prospective observational study (BLUE study)

HP QI Abstract: Improving Helicobacter pylori Testing in Patients With Acute Upper GI Bleeding Due to Peptic Ulcer Disease

Increasing Testing for Helicobacter pylori Infection to Improve Quality of Patient Care

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