Brief Article
Copyright ©2011 Baishideng Publishing Group Co.
World J Gastroenterol. Oct 28, 2011; 17(40): 4509-4516
Published online Oct 28, 2011. doi: 10.3748/wjg.v17.i40.4509
Table 1 Forrest classification
1 Actively bleeding ulcer
1a: Spurting
1b: Oozing
2 Non-actively bleeding ulcer
2a: Non-bleeding visible vessel
2b: Ulcer with surface clot
2c: Ulcer with red or dark blue spots
3 Ulcer with clean base
Table 2 Demographic, clinical and endoscopic characteristics of all patients with bleeding from peptic ulcers after consumption of nonsteroidal anti-inflammatory drugs, grouped according to whether they did or did not have Helicobacter pylori infection n (%)
Patients(n = 80)Helicobacter pylori negative(n = 36)Helicobacter pylori positive(n = 44)P-value
Males61 (76.3)28 (77.8)33 (75.0)0.771
Age (yr) (mean ± SD)61.2 ± 15.960.6 ± 18.361.7 ± 13.90.767
Smoker0.703
Non-smoker43 (53.8)21 (58.3)22 (50.0)
Current26 (32.5)10 (27.8)16 (36.4)
Ex-smoker11 (13.8)5 (13.9)6 (13.6)
Symptoms on presentation0.721
Hematemesis11 (13.8)4 (11.1)7 (15.9)
Melena58 (72.5)26 (72.2)32 (72.7)
Hematemesis and melena11 (13.8)6 (16.7)5 (11.4)
Initial mean hemoglobin (g/dL)9.2 ± 2.38.7 ± 2.29.6 ± 2.40.076
American Society of Anesthesiology class0.600
1-262 (77.5)26 (72.2)36 (81.8)
315 (18.8)8 (22.2)7 (15.9)
43 (3.8)2 (5.6)1 (2.3)
Complete Rockall score0.183
0-239 (48.8)19 (52.8)20 (45.5)
3-534 (42.5)12 (33.3)22 (50)
6-87 (8.8)5 (13.9)2 (4.5)
1Comorbidity27 (33.8)12 (33.3)15 (34.1)0.943
Occasional consumption of NSAIDs47 (58.8)19 (52.8)28 (63.6)0.326
Patients on chronic LD ASA33 (41.3)17 (47.2)16 (36.4)0.326
Other antiplatelet drugs5 (6.3)2 (5.6)3 (6.8)0.999
Anticoagulants2 (2.5)2 (5.6)0 (0)0.199
Other drugs39 (48.8)15 (41.7)24 (54.5)0.252
Locations of ulcers0.515
Duodenum alone41 (51.3)21 (58.3)20 (45.5)
Stomach alone29 (36.3)11 (30.6)18 (40.9)
Stomach and duodenum10 (12.5)4 (11.1)6 (13.6)
Forrest0.684
1a2 (2.5)1 (2.8)1 (2.3)
1b12 (15.0)6 (16.7)6 (13.6)
2a4 (5.0)1 (2.8)3 (6.8)
2b3 (3.8)1 (2.8)2 (4.6)
2c16 (20.0)10 (27.8)6 (13.6)
343 (53.8)17 (47.2)26 (59.1)
Table 3 Patients’ distribution on the basis of occasional or chronic consumption of nonsteroidal anti-inflammatory drugs
Occasional NSAID use
One NSAID35 (43.8)
Two NSAIDs (in sequence)9 (11.3)
Three NSAIDs (in sequence)2 (2.5)
NSAID + ticlopidine1 (1.3)
Chronic NSAID use
LD ASA alone18 (22.5)
LD ASA + another NSAID18 (10.0)
LD ASA + two other NSAIDs (in sequence)11 (1.3)
LD ASA + ticlopidine3 (3.8)
LD ASA + clopidogrel + NSAID11 (1.3)
LD ASA + LMWH1 (1.3)
LD ASA + LMWH + 2 NSAIDs (in sequence)11 (1.3)
Table 4 Frequency of positive diagnostic tests for Helicobacter pylori in culture-positive or culture-negative patients
Culture-positive(n = 38)Culture-negative(n = 42)
CLO test + tissue section-positive19 (23.8)6 (7.5)
CLO test positive5 (6.3)9 (11.3)
Tissue section-positive4 (5.0)8 (10.0)
Table 5 Performance of tests for Helicobacter pylori infection
Sensitivity% (95% CI)Specificity% (95% CI)PPV% (95% CI)NPV% (95% CI)Accuracy(%)False positive(%)False negative(%)
Culture of biopsy specimens38/4436/3638/3836/4274/800/366/44
86.4 (72.7-94.8)100 (90.3-100)100 (90.8-100)85.7 (71.5-94.6)-92.50-13.6
Helicobacter pylori on tissue sections29/4428/3629/3728/4357/808/3615/44
65.9 (50.1-79.5)77.8 (60.9-89.9)78.4 (61.8-90.2)65.1 (49.1-79.0)-71.3-22.2-34.1
Rapid urease test30/4427/3630/3927/4157/809/3614/44
68.2 (52.4-81.4)75.0 (57.8-87.9)76.9 (60.7-88.9)65.9 (49.4-79.9)-71.3-25-31.8
Helicobacter pylori on tissue sections and rapid urease test25/4436/3625/2536/5561/800/3619/44
56.8 (41.0-71.7)100 (90.3-100)100 (86.3-100)65.5 (51.4-77.8)-76.30-43.2
Anti-CagA26/4426/3626/3626/4452/8010/2618/44
59.1 (43.3-73.7)72.2 (54.8-85.8)72.2 (54.8-85.8)59.1 (43.3-73.7)-65-38.5-40.9