P2511 - Changes in Demographics and Prevalence of Helicobacter pylori in Gastric and Duodenal Ulcers at an Urban Tertiary Care University Hospital

Neil Sood, MD¹, Zachary Jurkowski, MD², Zachary E. Daitch, MD², Frank Friedenberg, MD, MS (Epi)¹, Stephen J. Heller, MD^1
1Temple University Hospital, Philadelphia, PA; ²Temple University, Philadelphia, PA

Introduction: Diagnosis and evaluation of peptic ulcer disease (PUD) is one of the most common indications for upper endoscopy, and Helicobacter pylori (HP) infection and NSAID use are the most common etiologies of the disease. HP incidence has declined worldwide, with more pronounced decreases in developed countries. We investigated whether a decline in HP infection occurred in our cohort of patients compared with nationally available estimates and if patient demographics, including race, were associated with HP incidence. Prior studies have cited the prevalence of HP in African Americans to be as high as 50-60% compared to the national US prevalence of 30%. Using data from patients seen at an academic medical center in an underserved area, we aim to elucidate the relationship between demographics and HP incidence.

Methods: We retrospectively queried our electronic health record for patients aged 18 or older diagnosed with PUD by endoscopy during a single year between 2019 and 2020. We collected information including age, gender, race, inpatient/outpatient diagnosis, Forrest classification of ulcer, location of ulcer, and HP status. We assessed association between these characteristics and HP status using Chi-squared analysis.

Results: 303 patients met inclusion criteria. 216 had gastric ulcers and 122 had duodenal ulcers. Among those, 34 patients had both gastric and duodenal ulcers. HP tests were performed on 227 patients, with 24.2% positivity. African American patients were most likely to have HP associated ulcers and Caucasian patients were least likely to have them (33.6% vs 3.8%, P< 0.001). There was no significant difference between HP prevalence based on age or ulcer location. Males were more likely to have HP ulcers than females (30.5% vs 18.9%, P=0.042).

Discussion: Prevalence of HP has decreased nationally over the last several years. However, as seen in our data, there has been a significant difference in the rate of HP affecting males and African Americans. Specifically, our data shows that HP rates have impacted these groups at a significantly higher rate than Caucasians and females. This data is especially significant at an inner-city hospital, where patients experience disparities in healthcare access. We aim to supplement this analysis with prior years’ data to further understand the differential decrease in HP amongst populations in our community. By doing so, we can better provide a framework for screening, treatment, and education of our patients who are at increased risk for HP.



Disclosures:


Neil Sood, MD¹, Zachary Jurkowski, MD², Zachary E. Daitch, MD², Frank Friedenberg, MD, MS (Epi)¹, Stephen J. Heller, MD¹. P2511 - Changes in Demographics and Prevalence of Helicobacter pylori in Gastric and Duodenal Ulcers at an Urban Tertiary Care University Hospital, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.