PEPTIC-ULCER HEMORRHAGE IN TARTU COUNTY, ESTONIA - EPIDEMIOLOGY AND MORTALITY RISK-FACTORS

Background: The aim of the study was to assess the epidemiology and mo rtality risk factors of peptic ulcer haemorrhage (PUH) in Tartu County , Estonia. Methods: In a prospective unselected defined area study, da ta for 144 patients aged greater than or equal to 15 years with new ca ses of PUH were analysed during a 2-year period. Results: The incidenc e of PUH was 57 per 100,000 adult population per year, increasing from 12 in patients aged 20-29 years to more than 135 in those greater tha n or equal to 70 years. The incidence was 2.3-fold higher for men. The incidence of gastric ulcer haemorrhage was 26 (men,33; women, 20) and that of duodenal ulcer 22 (men, 39; women, 9). Of the women 72% and o f the men 37% were greater than or equal to 60 years. Nonsteroidal ant iinflammatory drugs (NSAIDs) were used by 45% of the patients (64% of women, 36% of men). Helicobacter pylori infection was present in 93% o f the duodenal ulcer patients and in 81% of the gastric ulcer patients . Mortality (8%) was related to age, shock, haemoglobin <80 g/l, cardi ac comorbidity, and recurrence of haemorrhage. Conclusions: The incide nce of PUH is relatively high owing to a high incidence among the youn ger population in Tartu County. Women with PUH are older, have consume d more NSAIDs, and have mainly gastric ulcer; men are younger, have co nsumed less NSAIDs, and are prone to duodenal ulcer haemorrhage. H. py lori infection is common in PUH patients. Mortality risk factors coinc ide with those reported by other researchers.