Association between Helicobacter pylori infection and hospital-acquired upper gastrointestinal bleeding: a prospective case-control study

Abstract

Background: In-hospital bleeding increases hospital stays and mortality. Prolonged mechanical ventilation and coagulopathy are known risk factors. Helicobacter pylori (H. pylori) is associated with upper gastrointestinal bleeding (UGIB), but its role in hospitalized patients remains unclear. Objective: This study assessed the association between current H. pylori infection and UGIB in hospitalized patients. Methods: We conducted an age- and gender-matched case-control study with prospective data collection at Naresuan University Hospital, Thailand, from June 2021 to June 2022. Current H. pylori infection was determined using rapid tests with current infection marker. Multivariable conditional logistic regression was used to evaluate the association between H. pylori and UGIB. Results: Among 87 UGIB cases and 333 non-UGIB controls, the overall H. pylori infection prevalence was 32%. H. pylori infection was significantly associated with increased odds of in-hospital UGIB (adjusted OR: 1.97, 95% CI: 1.15–3.02). Prolonged mechanical ventilation was also linked to UGIB (adjusted OR: 2.23, 95% CI: 1.23–3.74). Conclusions: H. pylori infection, alongside mechanical ventilation, independently associates with the risk of nosocomial UGIB. Targeted testing for H. pylori in hospitalized patients with UGIB helps guide appropriate care.