S1371 Association of Cirrhosis With Development of Peptic Ulcer Disease: A Population-Based Perspective

INTRODUCTION: Multiple small studies have proved Cirrhosis as an independent risk for development of peptic ulcer disease (PUD) but there is a lack of large nationwide studies.Our aim is to evaluate for an association between PUD and Cirrhosis along with the comorbidities and demographic factors associated with the development of PUD among patients with cirrhosis. METHODS: A population-based retrospective cross-sectional analysis of the National Inpatient Sample (NIS) for 2014 was performed. Hospitalizations with cirrhosis and peptic ulcer disease were identified using International Classification of Diseases (9th Edition) Clinical Modification Procedural codes (ICD-9-CM) diagnosis codes which have been previously validated. The prevalence of PUD along with demographic characteristics and diagnosis of clinical importance were compared in patients with cirrhosis to those without cirrhosis. Weighted analyses using Chi-Square and paired Student’s t-test were performed to compare groups. Multivariable survey logistic regression was performed to find an association between cirrhosis and PUD. RESULTS: In 2014, out of a total of 29,751,963 hospitalizations, 710,375 (2.39%) occurred in patients with cirrhosis. There was higher prevalence of PUD hospitalisation among cirrhotic patients (1.47% vs. 0.45; P < 0.001) as compared to non-cirrhotic patients. In multivariable analysis, after adjusting for demographics, comorbidities, H. pylori infection and long term use of NSAIDS, anti coagulants, cirrhosis [Odds Ratio (OR): 2.70; Confidence Interval (CI): 2.56–2.85; P < 0.0001] was associated with markedly elevated odds of PUD hospitalisation. Additionally, female (1.6% vs 1.2%: P < 0.01), African american (1.7%) and Asian/others races (1.6%) were associated with higher rates of PUD among patients with cirrhosis (P < 0.01). Cirrhosis was also associated with higher mortality rate (8.6% vs 3.3%: P < 0.0001) among PUD patients. CONCLUSION: In this study we were able to demonstrate a significant association between development of PUD in patients with cirrhosis with a markedly increased mortality among those patients.More in-depth studies are warranted to identify risk factors and develop preventive strategies among these populations.