Yang Tsu Jung, Dhanasekar Krithika, Bhandari Renu, Muraleedharan Divya, Chirindoth Swathy S, Kaur Harpreet, Goswami Ruchir, Maiyani Prakash, Desai Maheshkumar, Moradiya Dharmeshkumar V, Devani Hiteshkumar, Patel Achint A
Hospital Medicine, MultiCare Good Samaritan Hospital, Puyallup, USA.
Internal Medicine, Sterling Medical Center, Sterling Heights, USA.
Cureus. 2021 Nov 6;13(11):e19315. doi: 10.7759/cureus.19315. eCollection 2021 Nov.
() plays an important role in causing peptic ulcer disease (PUD) in the general population. However, the role of in cirrhotic patients for causing PUD is obscure. There are various studies evaluating association with PUD in cirrhotic patients, but the results have been controversial. We sought to analyze the association of with the development of PUD in cirrhotic patients from the largest United States population-based database.
We analyzed Nationwide Inpatient Sample (NIS) and Healthcare Cost and Utilization Project (HCUP) data from 2017. Adult hospitalizations due to cirrhosis were identified by previously validated ICD-10-CM codes. PUD and were identified with the presence of ICD-10-CM codes in primary and secondary diagnosis fields, respectively. We performed weighted analyses using Chi-Square and paired Student's t-test to compare the groups. Multivariable survey logistic regression was performed to find an association of with PUD in cirrhotic patients.
Our study showed that the prevalence of infection was 2.2% in cirrhotic patients with PUD. In regression analysis, was found to be associated with PUD in cirrhotic patients (OR 15.1; 95% CI: 13.9-16.4; p <0.001) and non-cirrhotic patients (OR 48.8; 95% CI: 47.5-50.1; p <0.001). In the studied population, was more commonly seen in the age between 50 and 64 years (49.4% vs 44.1%; p <0.0001), male (63.4% vs 59.9%; p <0.0413), African American (16.3% vs 10.6%; p <0.0001), and Hispanic (26.2% vs 14.9%; p <0.0001). is more likely to be associated with complicated PUD hospitalizations (51.2% vs 44.2%; p <0.0067). Alcoholism and smoking were more common in group compared to those without (43.6% vs 35.8%; p <0.0001 and 33.7% vs 24.8% p <0.0001, respectively). Factors associated with increased odds of infection include African American (OR 2.3, 95% CI: 1.5-3.6), Hispanic (OR 2.6, 95% CI: 1.7-4.0), and smoking (OR 1.5, 95% CI: 1.1-2.2).
are associated with PUD and concurrent cirrhosis, although it is less prevalent than general population. African American, Hispanic, and smoking were independently associated with increased odds of infection. Further studies are required to better understand the epidemiology and confirm our findings.
（某因素）在普通人群消化性溃疡疾病（PUD）的发病中起重要作用。然而，（该因素）在肝硬化患者中导致PUD的作用尚不清楚。有多项研究评估了肝硬化患者中（该因素）与PUD的关联，但结果存在争议。我们试图从美国最大的基于人群的数据库分析（该因素）与肝硬化患者PUD发生的关联。
我们分析了2017年全国住院患者样本（NIS）和医疗成本与利用项目（HCUP）的数据。通过先前验证的ICD-10-CM编码识别因肝硬化导致的成人住院病例。PUD和（该因素）分别通过初级和二级诊断字段中ICD-10-CM编码的存在来识别。我们使用卡方检验和配对学生t检验进行加权分析以比较各组。进行多变量调查逻辑回归以发现肝硬化患者中（该因素）与PUD的关联。
我们的研究表明，患有PUD的肝硬化患者中（该因素）感染的患病率为2.2%。在回归分析中，发现（该因素）与肝硬化患者的PUD相关（比值比15.1；95%置信区间：13.9 - 16.4；p <0.001）以及非肝硬化患者（比值比48.8；95%置信区间：47.5 - 50.1；p <0.001）。在研究人群中，（该因素）在50至64岁年龄组中更常见（49.4%对44.1%；p <0.0001），男性（63.4%对59.9%；p <0.0413），非裔美国人（16.3%对10.6%；p <0.0001）和西班牙裔（26.2%对14.9%；p <0.0001）。（该因素）更可能与复杂PUD住院相关（51.2%对44.2%；p <0.0067）。与无（该因素）组相比，（该因素）组中酒精中毒和吸烟更常见（分别为43.6%对35.8%；p <0.0001和33.7%对24.8%，p <0.0001）。与（该因素）感染几率增加相关的因素包括非裔美国人（比值比2.3，95%置信区间：1.5 - 3.6），西班牙裔（比值比2.6，95%置信区间：1.7 - 4.0）和吸烟（比值比1.5，95%置信区间：1.1 - 2.2）。
（该因素）与PUD及并发肝硬化相关，尽管其患病率低于普通人群。非裔美国人、西班牙裔和吸烟与（该因素）感染几率增加独立相关。需要进一步研究以更好地了解其流行病学并证实我们的发现。
