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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

  • Original Article—Alimentary Tract
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Abstract

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.

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.

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.

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Abbreviations

CI:

Confidence intervals

NSAID:

Non-steroidal anti-inflammatory drug

OR:

Odds ratio

PPI:

Proton pump inhibitor

PTSD:

Post-traumatic stress disorder

PU:

Peptic ulcer

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Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aobaku, Sendai, 980-8574, Japan

    Takeshi Kanno, Kastunori Iijima, Tomoyuki Koike & Tooru Shimosegawa

  2. Department of Gastroenterology, Yamagata University Faculty of Medicine, Yamagata, Japan

    Yasuhiko Abe

  3. Department of Gastroenterology, Red Cross Ishinomaki Hospital, Ishinomaki, Japan

    Norihiro Shimada

  4. Department of Gastroenterology, Kesennuma City Hospital, Kesennuma, Japan

    Tatsuya Hoshi

  5. Department of Gastroenterology, Shiogama City Hospital, Shiogama, Japan

    Nozomu Sano

  6. Department of Gastroenterology, Osaki Citizen Hospital, Osaki, Japan

    Motoki Ohyauchi & Hirotaka Ito

  7. Department of Gastroenterology, Kurihara Central Hospital, Kurihara, Japan

    Tomoaki Atsumi & Hidetomo Konishi

  8. Department of Gastroenterology, South Miyagi Medical Center, Ogawara, Japan

    Sho Asonuma

Authors
  1. Takeshi Kanno
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  2. Kastunori Iijima
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  3. Tomoyuki Koike
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  4. Yasuhiko Abe
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  13. Tooru Shimosegawa
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Corresponding author

Correspondence to Kastunori Iijima.

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Kanno, T., Iijima, K., Koike, T. et al. 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. J Gastroenterol 50, 31–40 (2015). https://doi.org/10.1007/s00535-014-0940-4

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  • DOI: https://doi.org/10.1007/s00535-014-0940-4

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