Västerbotten Östergötland Västmanland Sörmland Norrbotten Dalarna Skåne Gotland Värmland SWEDEN Västra Götaland Västernorrland Stockholm Jämtland Kronoberg Jönköping Halland Gävleborg Örebro Kalmar Blekinge Uppsala
16.2 19.7 20.3 20.5 21.5 21.9 22.5 23.4 23.5 24.3 24.6 25.3 25.7 26.2 26.5 26.9 27.3 27.8 27.8 28.1 28.3 30.9 0
10
20
Deaths at hospital
Figure 145
30
40
2005–2007
50 Percent
Percentage of deaths within one year after hospitalisation for bleeding ulcer, 2008–2010. Also includes deaths at hospital. Age-standardised. Source: National Patient Register and Cause of Death Register, National Board of Health and Welfare
145 Bleeding Ulcer – 365-day Case Fatality Rate Bleeding ulcer is an acute life-threatening condition that requires hospitalisation. The risk increases substantially with age. Men are at greater risk than women of developing a bleeding ulcer. According to a 2011 report by the Swedish Council on Technology Assessment in Health Care (SBU), approximately 7–10 Swedes develop a bleeding ulcer every day and one person dies of the condition every three days. Presumably due to the declining prevalence of Helicobacter pylori in the general population, the report found that bleeding ulcer has become less common over time. The known risk factors for bleeding ulcer are advanced age, H. pylori infection and previous gastric ulcer, as well as consumption of analgesics or anti-inflammatory drugs containing non steroidal anti-inflammatory drugs, acetylsalicylic acid or lowdose acetylsalicylic acid. In recent years, selective serotonin reuptake inhibitors have also been shown to be associated with greater risk. While probably not causing ulcers, anticoagulants and corticosteroids appear to increase the risk of bleeding. A number of studies have concluded that comorbidity, primarily cardiovascular disease, makes it more likely that a person will develop a bleeding ulcer, but no consensus has emerged as to whether smoking, alcohol consumption and other lifestyle variables constitute independent risk factors.
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