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

Abstract

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.

The roles of estrogen and estrogen receptors in gastrointestinal disease (Review)

“…Peptic ulcers include both gastric and duodenal ulcers, and complications include upper GI bleeding, GI perforation and gastric outlet obstruction (43). Peptic ulcer disease is a multifactorial and complex digestive disease, and its pathogenesis is unclear (44). Gastric protective factors include mucous, endogenous bicarbonate, prostaglandins and antioxidant agents; whereas, pepsin, gastric acid, bile acids and endogenous oxidant agents are recognized as risk factors that could cause damage to the stomach (45).…”

Seasonal Impacts on the Incidence of Esophageal Variceal Hemorrhage: A Nationwide Analysis across a Decade

“…14 Kanotra et al utilized the United States NIS database to assess the seasonal variation in peptic ulcer disease. 20 They found that the admission rate peaked in February. 20 To our knowledge, the current study is the first to assess the seasonal pattern in esophageal variceal hemorrhage at a national scale within the United States.…”

“…20 They found that the admission rate peaked in February. 20 To our knowledge, the current study is the first to assess the seasonal pattern in esophageal variceal hemorrhage at a national scale within the United States. Advances in endoscopic therapy and intensive screening for esophageal varices have led to significant reduction in the overall mortality associated with esophageal variceal hemorrhage over the last several decades.…”

Definition, Pathogenesis, and Management of That Cursed Dyspepsia

“…Of the 1433 outpatients that they studied, 26% had a duodenal ulcer, 9% had GERD, 4% gallstones, and 3% gastric cancer 5 ; in 37% dyspeptic symptoms were considered as being functional in origin and assigned a diagnosis of functional dyspepsia (FD) in 22% and IBS in 15%. Although rates of duodenal ulcer disease have fallen dramatically and those of GERD have risen in the United States and Western Europe since then, [6][7][8][9] it must be remembered that duodenal and gastric ulcers remain common causes of dyspepsia elsewhere. [10][11][12][13][14] These geographic variations in the relative prevalence rates of organic and FD are undoubtedly related in large part to varying rates of H pylori infection 15 and also underscore a fundamental issue in the development of any diagnostic or therapeutic strategy in dyspepsia: the prevalence of organic disease.…”