4712 Seasonal variation in the incidence of upper gi bleeding.

Abstract

BACKGROUND: Peptic ulcer disease, a common cause of upper GI bleeding, is believed to have a seasonal variation in incidence. Similar variation in two main etiological factors, H. Pylori infection and NSAID use, has not been reported. Variation in prevalence of endoscopically confirmed ulcers may be due to an increased number of procedures rather than pathology itself. However, since acute upper gastrointestinal bleeding warrants endoscopy in each case, it may better reflect the seasonal differences in the burden of disease. AIM: We analyzed the monthly incidence of upper GI bleeding (by the mean of number of endoscopies with that indication) and NSAID use (by the number of visits with NSAID prescribed).We then analyzed the correlation between these variables. METHODS: Using a common endoscopy database (GI-TRAC) we counted the number of upper GI endoscopies performed each month in a period of 3 years (July 1995 to June 1998) in 4 medical centers.We estimated use of NSAIDS by counting visits with an NSAID prescription reported in the National Hospital Ambulatory Medical Care Survey (NHAMCS) 1997.We evaluated correlation between the monthly incidence of upper GI bleeding and NSAID use by linear regression analysis. RESULTS: Incidence of upper GI bleeding was on average 28% higher during the six month period December-May than between June-November (p