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- W2017689825 abstract "Background & AimsThe long-term prognosis of peptic ulcers associated with neither Helicobacter pylori nor nonsteroidal anti-inflammatory drugs (NSAIDs) is unknown.MethodsThis 7-year prospective cohort study recruited patients with bleeding ulcers from January to December 2000. H pylori–negative idiopathic bleeding ulcers were defined as having tested negative for H pylori, having no exposure to aspirin or analgesics within 4 weeks before endoscopy, and having no other identifiable causative factors. After ulcers healed, patients were divided into 2 groups: patients with prior H pylori–negative idiopathic bleeding ulcers (H pylori–negative idiopathic ulcer cohort; n = 120) and those with H pylori–positive, NSAID-negative bleeding ulcers who received eradication therapy (H pylori ulcer cohort; n = 213). Both groups were followed for ≤7 years without gastroprotective therapy. The primary endpoints were recurrent ulcer bleeding and mortality.ResultsThe 7-year cumulative incidence of recurrent ulcer bleeding was 42.3% (95% CI, 36.5%–48.1%) in the H pylori–negative idiopathic ulcer cohort and 11.2% (95% CI, 8.8%–13.6%) in the H pylori ulcer cohort (a difference of 31.1%; 95% CI, 27.7%–34.5%; P < .0001). Significantly more patients died in the H pylori–negative idiopathic ulcer cohort (87.6%; 95% CI, 83.0%–92.2%) than in the H pylori ulcer cohort (37.3%; 95% CI, 34.0%–40.6%) with a difference of 50.3% (95% CI, 49.0%–51.6%; P < .0001).ConclusionsPatients with history of H pylori–negative idiopathic bleeding ulcers have a high risk of recurrent ulcer bleeding and mortality. The long-term prognosis of peptic ulcers associated with neither Helicobacter pylori nor nonsteroidal anti-inflammatory drugs (NSAIDs) is unknown. This 7-year prospective cohort study recruited patients with bleeding ulcers from January to December 2000. H pylori–negative idiopathic bleeding ulcers were defined as having tested negative for H pylori, having no exposure to aspirin or analgesics within 4 weeks before endoscopy, and having no other identifiable causative factors. After ulcers healed, patients were divided into 2 groups: patients with prior H pylori–negative idiopathic bleeding ulcers (H pylori–negative idiopathic ulcer cohort; n = 120) and those with H pylori–positive, NSAID-negative bleeding ulcers who received eradication therapy (H pylori ulcer cohort; n = 213). Both groups were followed for ≤7 years without gastroprotective therapy. The primary endpoints were recurrent ulcer bleeding and mortality. The 7-year cumulative incidence of recurrent ulcer bleeding was 42.3% (95% CI, 36.5%–48.1%) in the H pylori–negative idiopathic ulcer cohort and 11.2% (95% CI, 8.8%–13.6%) in the H pylori ulcer cohort (a difference of 31.1%; 95% CI, 27.7%–34.5%; P < .0001). Significantly more patients died in the H pylori–negative idiopathic ulcer cohort (87.6%; 95% CI, 83.0%–92.2%) than in the H pylori ulcer cohort (37.3%; 95% CI, 34.0%–40.6%) with a difference of 50.3% (95% CI, 49.0%–51.6%; P < .0001). Patients with history of H pylori–negative idiopathic bleeding ulcers have a high risk of recurrent ulcer bleeding and mortality." @default.
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- W2017689825 date "2009-08-01" @default.
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- W2017689825 title "High Incidence of Mortality and Recurrent Bleeding in Patients With Helicobacter pylori–Negative Idiopathic Bleeding Ulcers" @default.
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- W2017689825 doi "https://doi.org/10.1053/j.gastro.2009.05.006" @default.
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