Accommodation in a refugee shelter as a risk factor for peptic ulcer bleeding after the Great East Japan Earthquake: a case–control study of 329 patients

Takeshi Kanno, Kastunori Iijima, Tomoyuki Koike, Yasuhiko Abe, Norihiro Shimada, Tatsuya Hoshi, Nozomu Sano, Motoki Ohyauchi, Hirotaka Ito, Tomoaki Atsumi, Hidetomo Konishi, Sho Asonuma, Tooru Shimosegawa

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)

Abstract

Methods: Clinical data of all peptic ulcer subjects endoscopically detected at the 7 major hospitals in the middle of the stricken area during the 3 months after the earthquake were retrospectively collected. Based on endoscopic and laboratory findings, peptic ulcer cases were divided into 227 bleeding ulcer cases and 102 non-bleeding controls. Other than ordinary risk factors for bleeding ulcers, the refugee shelter was included in the analysis as a unique confounder after the earthquake. Multiple logistic regression analyses were used to adjust for potential confounders.

Background: We have reported that the total number of peptic ulcers (PUs) had increased 1.5-fold after the Great East Japan Earthquake compared with those of the previous year, and that hemorrhagic ulcers were more prominently increased by 2.2-fold. The aim of this study is to determine the risk factors for bleeding ulcers after the Great East Japan Earthquake.

Results: Eighty-seven (27 %) of 329 PUs emerged from refuge shelters, and the majority (76 of 87) of PUs occurring in such shelters was the bleeding type. Multivariate regression showed that residence in a shelter was a strong risk factor for ulcer bleeding with OR (95 % CI): 4.4 (2.1–9.6, p < 0.0001), independent of the progressiveness of ulcer diseases.

Conclusions: Accommodation in a refugee shelter can be a strong risk factor for ulcer bleeding after a large-scale disaster. Since acid-suppressive drugs are supposed to decrease the risk for stress-induced ulcer bleeding, our results will encourage effective use of a limited medical resource in such catastrophic events.

Original languageEnglish
Pages (from-to)31-40
Number of pages10
JournalJournal of gastroenterology
Volume50
Issue number1
DOIs
Publication statusPublished - 2014 Jan

Keywords

  • Bleeding peptic ulcers
  • Earthquake
  • Refugee shelter
  • Risk factors

ASJC Scopus subject areas

  • Gastroenterology

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