Article

Causes of death in duodenal and gastric ulcer.

Gastroenterology (Impact Factor: 12.82). 12/1977; 73(5):1000-4.
Source: PubMed

ABSTRACT An analysis has been made of 235 deaths that occurred among 1905 patients with peptic ulcer who constituted a random sample of the occurrence of ulcer disease in an area of Denmark comprising half a million inhabitants. The disease itself, according to the death certificate, was considered the primary cause of death in 10% of the cases; half of these had been operated on immediately before death. The other patients died more frequently than expected from the following causes: chronic bronchitis, pulmonary emphysema, cancer of the lung, cirrhosis of the liver, and cancer of the pancreas. Although the comorbidity with chronic bronchitis and emphysema was especially pronounced in patients with gastric ulcer, the association with liver cirrhosis and cancer of the pancreas occurred only in patients with duodenal ulcer. In women the mortality rate attributable to cardiac and vascular diseases was lower than expected. No excess coincidence of suicide was found. Berkson's fallacy is considered to be of much less importance as a possible explanation of the comorbidity found in the present study than in the majority of publications concerned with this question.

0 Bookmarks
 · 
118 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: The present review concentrates on environmental factors which influence the outcome of peptic ulcer disease by acting from the outside. Endogenous risk factors, such as acid output, pepsin secretion and serum pepsinogen, gastritis and mucosal defense, blood group, and secretor status, are only dealt with when they help to explain the mechanism by which exogenous risk factors affect the upper gastrointestinal mucosa. After outlining the wax and wane of peptic ulcer, it is concluded that these changes resulted from similar temporal patterns of occupational workload in the general population. Cross sectional studies also support the contention of occupational workload being a risk factor in peptic ulcer, explaining several characteristic features of peptic ulcer, such as its sex, race, and social class distribution, increased incidence in immigrant workers, seasonal variation, healing by bed rest, and urban versus rural distribution. Susceptible subjects may react to a rise in occupational workload and acute exposure to stressful life events by increased gastric secretion which, in turn, leads to ulceration and symptoms. Cigarette smoking, intake of aspirin and related drugs, dietary salt, and alcohol abuse represent additional environmental risk factors, which form the etiologic link of the association of peptic ulcer with chronic lung disease, rheumatoid arthritis, hypertensive disease, and liver cirrhosis, respectively.
    Scandinavian journal of gastroenterology. Supplement 02/1988; 155:119-40.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Ascitic fluid leukocytosis occurring in the cirrhotic patient in the absence of positive peritoneal cultures is often difficult to explain. A unique case of a patient with alcoholic cirrhosis, sterile ascites, and ascitic fluid leukocytosis demonstrated prior to the perforation of a duodenal ulcer has been presented. Based on the patient's clinical course and the pathological events in peptic ulceration of the stomach and duodenum, it is possible to postulate an explanation for the sterile ascitic fluid leukocytosis observed in this patient.
    Digestive Diseases and Sciences 11/1978; 23(12):1132-1136. · 2.26 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study was to investigate whether any specific causes of death were more frequent than expected in an Australian group of 305 gastric ulcer patients (131 men, 174 women) who had died in New South Wales between 1 January 1974 and 31 December 1983. The distribution of causes of death among the ulcer population deaths was compared with that among the New South Wales population deaths, after adjusting for sex, 5-year age group, and time period of death (1974-1978, 1979-1983). Causes of death were ascertained from death certificates. Deaths due to peptic ulcer, liver cirrhosis, and diffuse pulmonary disease were more frequent than expected (p less than 0.05). The associations found with these other diseases accord with those found in previous surveys on causes of death in gastric ulcer patients and in studies of living gastric ulcer populations. Overall, the combined evidence suggests that liver cirrhosis and diffuse pulmonary disease are associated with gastric ulcer.
    Scandinavian Journal of Gastroenterology 09/1991; 26(8):806-11. · 2.33 Impact Factor