TIME TRENDS IN PEPTIC-ULCER DISEASE AND IN GASTRITIS AND DUODENITIS - MORTALITY, UTILIZATION, AND DISABILITY IN THE UNITED-STATES

被引：11

作者：

BLOOM, BS ^{[1
]}

KROCH, E ^{[1
]}

机构：

[1] VILLANOVA UNIV,VILLANOVA,PA 19085

来源：

JOURNAL OF CLINICAL GASTROENTEROLOGY | 1993年 / 17卷 / 04期

关键词：

PEPTIC ULCER DISEASE; GASTRITIS; DUODENITIS; EPIDEMIOLOGY;

D O I：

10.1097/00004836-199312000-00015

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

This study compared the results of two analytic methods testing the effects of histamine H-2 receptor antagonists on acid-related conditions. We examined the rates of peptic ulcer disease-related and of gastritis- and duodenitis-related mortality, hospitalizations, surgery, physician visits, work-loss, and disability retirements in the United States from 1970 to 1986. First, we performed a nonparametric epidemiologic analysis. For mortality, hospitalizations, and surgeries, age-specific rates continued their historic decline; there was an additional large one-time decline of operations in 1978. Trends were stronger for peptic ulcer than for gastritis and duodenitis. From pooled annual data, rates of physician visits and physician referral declined for peptic ulcer and for gastritis and duodenitis in the post-1977 period (p = 0.0001). Work-loss and other restrictions on normal daily activities also declined for persons with peptic ulcer and with gastritis and duodenitis (p = 0.0001). Second, we fit a parametric model by maximum likelihood to test specific population effects of H-2 blockers. The model indicated that people greater-than-or-equal-to 65 years old had increasing peptic ulcer mortality rates after 1977 (p < 0.001), while people < 65 years old had a deceleration in rates of decline (p < 0.01). Hospitalization rates for peptic ulcer and for gastritis and duodenitis increased in the elderly after 1977 (p < 0.01) and decreased among those < 65 years old. Both age groups experienced similar declining trends of operations for peptic ulcer; these were not significantly different when pre- and post-1977 periods were compared. The rate of disability retirement declined sharply for workers greater-than-or-equal-to 50 years old (p < 0.01) and for those < 50 years of age (p < 0.001). The inconclusive results of the parametric analysis, plus only partial congruence between parametric and nonparametric analyses, emphasize the difficulty of relating diverse effects over time to a single, new, more effective treatment.

引用

页码：333 / 342

页数：10

共 32 条

[11] Snedecor G.W., Cochran W.G., Statistical methods, (1967)
[12] Box G.E.P., Cox D.R., An analysis of transformations, J R Stat Soc, pp. 211-243, (1962)
[13] Jeng Y.J., Martin A., Residuals in multiple regression analysis, J Pharm Sci, 74, pp. 1053-1057, (1985)
[14] Bloom B.S., Fenderick A.M., Ramsey S.D., Changes in peptic ulcer and gastritis/duodenitis in Great Britain, 1970-1985, J Clin Gastroenterol, 12, pp. 100-108, (1990)
[15] Bloom B.S., Fox N.A., Jacobs J., Patterns of care and expenditures by California medicaid for peptic ulcer and other acid-related diseases, J Clin Gastroenterol, 11, pp. 615-620, (1989)
[16] Bloom B.S., Gessner U., Long-term technology assessment: Mortality, hospitalization and work-loss due to peptic ulcer and gastritis/duodenitis in the Federal Republic of Germany, Int J Technol Assess Health Care, 5, pp. 215-226, (1989)
[17] Susser M., Period effects, generation effects and age effects in peptic ulcer mortality, J Chron Dis, 35, pp. 29-40, (1982)
[18] Sonnenberg A., Disability pensions due to peptic ulcer in Germany between 1953 and 1983, Am J Epidemiol, 122, pp. 106-111, (1985)
[19] Walt R., Logan R., Katschinski B., Ashley J., Langman M., Rising frequency of ulcer perforation in elderly people in the United Kingdom, Lancet, 1, pp. 489-492, (1986)
[20] Guess H.A., West R., Strand L.M., Et al., Fatal upper gastrointestinal hemorrhage or perforation among users and nonusers of nonsteroidal anti-inflammatory drugs in Saskatchewan, Canada 1983, J Clin Epidemiol, 41, pp. 35-45, (1988)

← 1 2 3 4 →