Influence of climatic factors in the incidence of upper gastrointestinal bleeding

Nomura, Tetsuya; Ohkusa, Toshifumi; Araki, Akihiro; Chuganji, Yoshimichi; Momoi, Masaru; Takashimizu, Ichizen; Watanabe, Mamoru

doi:10.1046/j.1440-1746.2001.02486.x

Cited by 37 publications

(46 citation statements)

References 15 publications

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“…Numerous studies have investigated diurnal, weekly, or seasonal variations in the onset of different diseases, such as cardiovascular diseases [7,[22][23][24] , cerebrovascular diseases [25,26] , and psychiatric disorders [27][28][29] , as well as complicated (including hemorrhage and perforation) and uncomplicated PUs [8][9][10][11] , for which the highest incidences are in winter. This seasonal fluctuation of PU may be affected by several factors, including climatic factors [30] , increased intake of NSAIDs in winter [31] , significantly increased number of H. pylori infections in winter [32] , and variations in alcohol consumption [33] .…”

Section: Discussionmentioning

confidence: 99%

“…An Italian study shows that the number of PU cases is lower in summer than in winter, spring, or autumn [7] . Studies from China and Japan also report that cases of hemorrhage caused by PU increase during the winter and decrease during summer [8][9][10] . Furthermore, researchers in Turkey have observed a peak in the number of PU incidences in winter, consistent with findings of previous studies [11] .…”

Section: Introductionmentioning

confidence: 97%

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Weekly pattern of emergency room admissions for peptic ulcers: A population-based study

Tsai

Lin²,

Pai

et al. 2015

WJG

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AIM: To investigate variations in the incidence of peptic ulcers (PUs) in Taiwan by day of the week within age subgroups. METHODS:Ambulatory care data were retrieved from the Longitudinal Health Insurance Database 2000. There were 7204 subjects ≥ 18 years-old with an emergency room admission claim for the treatment of PUs, resulting in a total of 9234 emergency room visits for PUs between 2009 and 2011. Data was divided into the seven days of the week and an additional variable for holidays. One-way analysis of variance was used to examine associations among the daily mean number of PU emergency room admissions and holidays/ weekends/weekdays. RESULTS:One-way analysis of variance showed that there was a significant difference in emergency room admissions for PUs by the day of the week (P < 0.001), with admission more likely to occur on Sundays or holidays than weekdays within the total and working populations. The weekday patterns of admission were similar for the patients aged 18-64 years and ≥ 65 years of age. Holidays, followed by Sundays, had higher PU admissions than the mean daily PU emergency room admissions. Furthermore, inclusion of only those treated for PUs with hemorrhage or perforation, Sundays and holidays had higher mean emergency room admissions than other days. Inclusion of patients who diagnosed with Helicobacter pylori infection, only holidays had higher mean emergency room admissions than other days. Inclusion of patients who had been prescribed non-steroidal anti-inflammatory drugs (NSAIDs) for over Observational Study ORIGINAL ARTICLE30 d, Sundays and holidays had higher mean PU ER admissions than other non-holiday weekdays.CONCLUSION: There is a higher incidence of emergency room admission for PUs on weekends than on weekdays for the total and working populations.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Weekly pattern of emergency room admissions for peptic ulcers: A population-based study

Tsai

Lin²,

Pai

et al. 2015

WJG

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“…The most frequent complications of PUD were hemorrhage and perforation. As for hemorrhage, autumn or winter peaks have been found again in the USA [27], Russia [28], Taiwan [29,30], and Japan [31]. Thomopoulos et al [32] in Greece, Yen et al [33] in Taiwan, and Rodriguez et al in Mexico [34] found summer/autumn peaks, while Lopez-Cepero et al [35] in Spain found no seasonality, and in Norway Svanes et al [36] reported a 6-month time pattern.…”

Section: Discussionmentioning

confidence: 99%

“…Although the answer is far from being conclusive several factors have been claimed to play a role in PUD seasonality. Concerning severe PUD, Nomura et al [31] found that the incidence of hematemesis due to GU over the year showed an inverse temporal relationship to temperature and relative humidity and a parallel relationship with atmospheric pressure. Liu et al [24,45] found a close relationship between detectable PUD and average temperature, average highest and lowest temperature, average atmospheric pressure, and the average dew point temperature.…”

Section: Discussionmentioning

confidence: 99%

Seasonal pattern of peptic ulcer hospitalizations: analysis of the hospital discharge data of the Emilia-Romagna region of Italy

et al. 2010

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BackgroundPrevious studies have reported seasonal variation in peptic ulcer disease (PUD), but few large-scale, population-based studies have been conducted.MethodsTo verify whether a seasonal variation in cases of PUD (either compicated or not complicated) requiring acute hospitalization exists, we assessed the database of hospital admissions of the region Emilia Romagna (RER), Italy, obtained from the Center for Health Statistics, between January 1998 and December 2005. Admissions were categorized by sex, age (<65, 65-74, ≥ 75 yrs), site of PUD lesion (stomach or duodenum), main complication (hemorrhage or perforation), and final outcome (intended as fatal outcome: in-hospital death; nonfatal outcome: patient discharged alive). Temporal patterns in PUD admissions were assessed in two ways, considering a) total counts per single month and season, and b) prevalence proportion, such as the monthly prevalence of PUD admissions divided by the monthly prevalence of total hospital admissions, to assess if the temporal patterns in the raw data might be the consequence of seasonal and annual variations in hospital admissions per se in the region. For statistical analysis, the χ2 test for goodness of fit and inferential chronobiologic method (Cosinor and partial Fourier series) were used.ResultsOf the total sample of PUD patients (26,848 [16,795 males, age 65 ± 16 yrs; 10,053 females, age 72 ± 15 yrs, p < 0.001)], 7,151 were <65 yrs of age, 8,849 between 65 and 74 yrs of age, and 10,848 ≥ 75 yrs of age. There were more cases of duodenal (DU). (89.8%) than gastric ulcer (GU) (3.6%), and there were 1,290 (4.8%) fatal events. Data by season showed a statistically difference with the lowest proportion of PUD hospital admissions in summer (23.3%) (p < 0.001), for total cases and rather all subgroups. Chronobiological analysis identified three major peaks of PUD hospitalizations (September-October, January-February, and April-May) for the whole sample (p = 0.035), and several subgroups, with nadir in July. Finally, analysis of the monthly prevalence proportions yielded a significant (p = 0.025) biphasic pattern with a main peak in August-September-October, and a secondary one in January-February.ConclusionsA seasonal variation in PUD hospitalization, characterized by three peaks of higher incidence (Autumn, Winter, and Spring) is observed. When data corrected by monthly admission proportions are analyzed, late summer-autumn and winter are confirmed as higher risk periods. The underlying pathophysiologic mechanisms are unknown, and need further studies. In subjects at higher risk, certain periods of the year could deserve an appropriate pharmacological protection to reduce the risk of PUD hospitalization.

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“…Liu, et al [28], in their study in Nanning, China concluded that there existed a relationship between the meteorological factors and the onset of peptic ulcers such that the winter and the spring season were predominant over summer and fall, supporting our study. Another study concluded that hemorrhages due to gastric ulcers were largely seen in winter months, when the mean temperature and mean vapor pressure were low, while the mean atmospheric pressure was high, contrary to summer when there was a high mean temperature and mean vapor pressure, while the mean atmospheric pressure was low, thus lower incidence [29]. …”

Section: Discussionmentioning

confidence: 99%

Seasonal Variations and Trends in Hospitalization for Peptic Ulcer Disease in the United States: A 12-Year Analysis of the Nationwide Inpatient Sample

Kanotra¹,

Ahmed²,

Patel³

et al. 2016

Cureus

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BackgroundPeptic ulcer disease (PUD) is a major public health burden significantly impacting the cost of hospitalization in the United States (US). We examined the trends, characteristics, complications, cost, and seasonality of PUD-related hospitalizations from 2000 to 2011.MethodsWith the use of the Nationwide Inpatient Sample from 2000 through 2011, we identified PUD-related hospitalizations using the International Classification of Diseases (ICD-9), 9th Revision, and the Clinical Modification code 531.00 to 534.91 as the principal discharge diagnosis. The total number of hospitalizations for each calendar month of the year were added over a 12-year period, and this number was divided by the number of days in that particular month to obtain the mean hospitalizations per day for each month.ResultsThe study found that 351,921 hospitalizations with the primary discharge diagnosis of peptic ulcer disease (PUD) occurred in the US between 2000 and 2011. This number dropped significantly from 49,524 to 17,499 between 2000 and 2011, and the rate of PUD-related mortality decreased from 4.3% to 3.1%. The mean age of the study population was 66.2 ± 17.4 years; 52.3% were males, and 56.8% were white. The number of hospitalizations in the US peaked in the spring season (916/day), and reached a nadir in the fall season (861/day). The mean cost of PUD hospitalization increased significantly from $11,755 in 2001 to $13,803 in 2011 (relative increase of 17%; p <0.001).ConclusionThe incidence of PUD and its mortality has decreased significantly in the last decade, but its economic burden on the healthcare system remains high. A seasonal pattern of PUD hospitalization showed a peak in PUD-related admissions in the spring season and a trough in the fall season.

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Influence of climatic factors in the incidence of upper gastrointestinal bleeding

Abstract: We found that the incidence of hematemesis because of GU had an inverse relationship to temperature and vapor pressure, and had a parallel relation to atmospheric pressure. Therefore, climatic factors may play an important role in hemorrhage from GU.

Cited by 37 publications

References 15 publications

Weekly pattern of emergency room admissions for peptic ulcers: A population-based study

Weekly pattern of emergency room admissions for peptic ulcers: A population-based study

Seasonal pattern of peptic ulcer hospitalizations: analysis of the hospital discharge data of the Emilia-Romagna region of Italy

Seasonal Variations and Trends in Hospitalization for Peptic Ulcer Disease in the United States: A 12-Year Analysis of the Nationwide Inpatient Sample

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