Risk Factors For Recurrence of Peptic Ulcer Disease: A Retrospective Study In Tertiary Care Referral Center

Abstract

Backgrounds: Peptic ulcer disease (PUD) is a common gastrointestinal tract disease characterized by mucosal damage secondary to pepsin and gastric acid secretion. The aim of this study was to evaluate the five-year recurrence rate for treated patients with PUD and risk factors contributing to PUD relapses.Methods: From 2016 through 2021, all patients with endoscopy-proved PUD were identified by reviewing medical records (Best-Care system). Possible risk factors including smoking, non-steroidal anti-inflammatory drugs (NSAIDs), aspirin, alcohol, caffeine, and steroid were analyzed by univariate analysis. Treatment outcomes, 5-year recurrence rate, and mortality rate were assessed.Results: Among 223 patients, there were 187 (83.8%), who diagnosed endoscopy-proved PUD and 36 (16.2%), who diagnosed clinical PUD. Among them, 126 (56.5%) patients were males and the mean age was 62±2 years. The five years recurrence rate of PUD was 30.9%. There was no significant difference in the recurrence rate between the duodenal ulcer (33.3%) and the gastric ulcer (28.8%). By univariate analysis, the use of steroid and NSAID and H. pylori infection were potential risk factors for PUD (P < 0.005). The common complication of PUD was gastrointestinal bleeding (34.1%). Patients who had a complicated PUD were associated with a higher rate of recurrence (45.9%) compared to the uncomplicated PUD (19.2%) (P > 0.05). Conclusion: Our findings demonstrated that the five years recurrence rate of PUD was 30.9%. The use of steroid and NSAID and H. pylori infection were risk factors for recurrence of PUD. PUD places a significant burden on health care systems. Therefore, a multicenter prospective study is needed for effective management to prevent recurrence and complications of PUD.