Chronic obstructive pulmonary disease is associated with increased recurrent peptic ulcer bleeding risk

- Patients with COPD had higher risk of developing recurrent PUB.
- COPD patients using steroids carried higher risk of recurrent PUB than those that didn't.
- COPD patients increased morbidity when recurrent PUB occurred.

BackgroundThe association between chronic obstructive pulmonary disease (COPD) and the risk of recurrent peptic ulcer bleeding (PUB) remains unclear. In this study, we compared the risk of recurrent PUB between patients with and those without COPD.MethodsUsing the Taiwan National Health Insurance Research Database, we first selected patients newly diagnosed with PUB in 2002-2009. Two groups comprising 13,732 COPD cases and 13,732 non-COPD matched controls were created using propensity score matching, thereby making the differences in basic demographics, medication use, and disease conditions between the two groups negligible. Cox proportional hazard regression was used to evaluate the risk of recurrent PUB during the follow-up period.ResultsThe cumulative recurrence rate of PUB was significantly higher in the patients with COPD than in the non-COPD matched controls (2 years: 10.8% vs 9.3%; 6 years: 18.3% vs 15.7%, P all < 0.05), with an adjusted hazard ratio (HR) of 1.17 (95% confidence interval [CI], 1.08-1.26, P < 0.001) and 1.19 (95% CI, 1.12-1.26, P < 0.001) within 2-year and 6-year follow-ups, respectively. Patients with COPD using steroids were at a marginally higher risk of recurrent PUB than those who did not use steroids. Multivariate stratified analysis revealed similar results in many subgroups.ConclusionsThe risk of recurrent PUB is higher in patients with COPD than in patients without COPD.