OBJECTIVE: Upper gastrointestinal bleeding (UGIB) is a cause of Emergency Department (ED) visits. Peptic ulcer secondary to H.
pylori (HP) infection and/or to the use of NSAIDs
is the most frequent cause. The aim of the study
is to evaluate directly in the ED the prevalence of
HP infection through Urea Breath test (UBT) in
patients admitted to the ED for UGIB.
PATIENTS AND METHODS: We enrolled 87 patients (58M/29F) with a mean age of 63.8 + 11.7
yrs with an active UGIB who performed EGDS
RESULTS: 34.4% of patients performing EGDS
and UBT resulted positive to HP. Peptic ulcer was
present in 20/30 (66.7%) of HP+ compared to 20/57
(35.1%) of HP- (p<0.001), and also gastritis and/or
duodenitis were mostly present in HP+ (23.3% vs.
15.8%) (p<0.05). A biopsy was performed in only
31% of patients with a positive rate of 33.3%. In 78%
we obtained a correspondence between UBT and
biopsy results. Compared to biopsy result, we obtained for UBT a positive predictive value (PPV) of
71% and a negative predictive value (NPV) of 80%.
Taking the UBT as a gold standard, we obtained for
biopsies a PPV of 69% and a NPV of 85%.
CONCLUSIONS: Our study confirms that the
use of UBT directly in ED in patients with UGIB allows for a rapid, reliable and non-invasive diagnosis of HP infection as a causative agent for bleeding, thus permitting a right etiological treatment.
- Emergency Department
- Helicobacter pylori
- Upper gastrointestinal bleeding
- Urea breath test