Hospitalisation of and mortality from bleeding peptic ulcer in Sweden: a nationwide time-trend analysis

Aliment Pharmacol Ther. 2011 Mar;33(5):578-84. doi: 10.1111/j.1365-2036.2010.04562.x. Epub 2011 Jan 6.


Background: Time-trend analyses of incidence and mortality in bleeding peptic ulcer show divergent results.

Aim: To conduct a detailed national analysis of hospitalisation of and mortality from bleeding peptic ulcer in Sweden.

Method: Data from all hospitalisations at departments with primary responsibility for patients with bleeding ulcer in Sweden, with main diagnosis or co-diagnosis of bleeding ulcer from 1987 to 2005 were retrieved from the Hospital Discharge Register. A validation study was performed due to an uncertainty in diagnostic setting after the introduction of ICD-10 in 1997. Annual hospitalisation rates per 100 000 inhabitants in relation to gender, age and ulcer location were calculated as well as age-standardised 30-day mortality rates.

Results: Hospitalisations for bleeding ulcer decreased from 63.9 to 35.3 per 100 000 inhabitants per year during the study period. The decrease was greater among men (men: from 80.4 to 40.9; women: from 47.7 to 29.7) and in younger age groups. Bleeding gastric ulcer decreased in both genders, and bleeding duodenal ulcer decreased most among men, but was stable in a subgroup of elderly women. Median age increased from 70 to 76 years. Standardised 30-day mortality increased from 5.3% to 6.2%. The increased mortality was found in those aged more than 65 years and with duodenal ulcer disease, whereas mortality remained unchanged in those with bleeding gastric ulcer.

Conclusion: Hospitalisation rates for bleeding peptic ulcer have markedly decreased in Sweden in all age groups. The 30-day mortality is low compared with other nationwide studies in the western world, but has increased among patients with duodenal ulcer disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Helicobacter Infections / complications*
  • Helicobacter pylori / isolation & purification
  • Hospitalization / statistics & numerical data*
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Peptic Ulcer / epidemiology*
  • Peptic Ulcer / mortality
  • Peptic Ulcer Hemorrhage / mortality
  • Peptic Ulcer Hemorrhage / therapy*
  • Risk Factors
  • Sweden / epidemiology
  • Time Factors