Journal of Gastroenterology
Volume 50, Issue 1, 2014, Pages 31-40

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 (Article)

Kanno T. , Iijima K.* , Koike T. , Abe Y. , Shimada N. , Hoshi T. , Sano N. , Ohyauchi M. , Ito H. , Atsumi T. , Konishi H. , Asonuma S. , Shimosegawa T.
  • a Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aobaku, Sendai, 980-8574, Japan
  • b Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aobaku, Sendai, 980-8574, Japan
  • c Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aobaku, Sendai, 980-8574, Japan
  • d Department of Gastroenterology, Yamagata University, Yamagata, Japan
  • e Department of Gastroenterology, Red Cross Ishinomaki Hospital, Ishinomaki, Japan
  • f Department of Gastroenterology, Kesennuma City Hospital, Kesennuma, Japan
  • g Department of Gastroenterology, Shiogama City Hospital, Shiogama, Japan
  • h Department of Gastroenterology, Osaki Citizen Hospital, Osaki, Japan
  • i Department of Gastroenterology, Osaki Citizen Hospital, Osaki, Japan
  • j Department of Gastroenterology, Kurihara Central Hospital, Kurihara, Japan
  • k Department of Gastroenterology, Kurihara Central Hospital, Kurihara, Japan
  • l Department of Gastroenterology, South Miyagi Medical Center, Ogawara, Japan
  • m Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aobaku, Sendai, 980-8574, Japan

Abstract

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.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. © 2014, Springer Japan.

Author Keywords

Refugee shelter Earthquake risk factors Bleeding peptic ulcers

Index Keywords

refugee multicenter study clinical trial demography human sex difference Refugees middle aged statistics and numerical data Aged Residence Characteristics earthquake Humans Earthquakes male Japan female Aged, 80 and over very elderly risk factor Risk Factors age Sex Factors Age Factors Case-Control Studies case control study Peptic Ulcer Hemorrhage
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84893684780&doi=10.1007%2fs00535-014-0940-4&partnerID=40&md5=f6043a351938e58d2ab5e3922078e975
DOI: 10.1007/s00535-014-0940-4
ISSN: 09441174
Cited by: 6
Original Language: English