Trends and predictors for vagotomy when performing oversew of acute bleeding duodenal ulcer in the United States

Brian C. Reuben, Greg Stoddard, Robert Glasgow, Leigh A Neumayer

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

In the era of Helicobacter pylori treatment, the role of vagotomy in bleeding duodenal ulcers is debatable. National outcomes were evaluated to determine the current surgical treatment and use of vagotomy for bleeding duodenal ulcers. Data from the Nationwide Inpatient Sample (NIS) were used from years 1999 to 2003. Patients were selected using diagnostic codes for acute duodenal ulcer bleed and procedure codes for simple oversew of a bleeding ulcer and vagotomy. Data were analyzed using multiple linear and logistic regression. Between 1999 and 2003, 100,931 patients with an acute bleeding duodenal ulcer were identified. Over time, there was a decrease in the number of acute bleeding ulcers (p∈=∈0.027) and a decrease in the number of vagotomies (p∈=∈0.027). A high co-morbidity index [odds ratio (OR), 0.60, p∈=∈0.017], operation in the Midwest (OR 0.50, p∈<∈0.001) and operation in the West (OR 0.68, p∈=∈0.034) were predictive of no vagotomy during surgery for a bleeding duodenal ulcer. A vagotomy is not commonly performed during surgical treatment of an acute bleeding duodenal ulcer. This variation in practice was not fully explained by patient characteristics. We must seek new evidence to determine the safety of combined medical and surgical management of this clinical problem.

Original languageEnglish (US)
Pages (from-to)22-28
Number of pages7
JournalJournal of Gastrointestinal Surgery
Volume11
Issue number1
DOIs
StatePublished - Jan 2007
Externally publishedYes

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Vagotomy
Duodenal Ulcer
Hemorrhage
Odds Ratio
Ulcer
Helicobacter pylori
Inpatients
Linear Models
Therapeutics
Logistic Models
Morbidity
Safety

Keywords

  • Bleeding
  • Duodenal ulcer
  • Outcomes
  • Vagotomy

ASJC Scopus subject areas

  • Surgery

Cite this

Trends and predictors for vagotomy when performing oversew of acute bleeding duodenal ulcer in the United States. / Reuben, Brian C.; Stoddard, Greg; Glasgow, Robert; Neumayer, Leigh A.

In: Journal of Gastrointestinal Surgery, Vol. 11, No. 1, 01.2007, p. 22-28.

Research output: Contribution to journalArticle

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