S. Seo, Tae Jun Kim, Y. J. Choi, C. S. Bang, Yong Kang Lee, M. Lee, S. Nam, W. Shin
{"title":"幽门螺杆菌感染患者的临床特征和治疗途径——采用通用数据模型的单中心队列研究","authors":"S. Seo, Tae Jun Kim, Y. J. Choi, C. S. Bang, Yong Kang Lee, M. Lee, S. Nam, W. Shin","doi":"10.7704/kjhugr.2022.0010","DOIUrl":null,"url":null,"abstract":"Background/Aims: Changing trends in the Helicobacter pylori ( H. pylori ) eradication protocol have not been investigated after the publication of the third-revised Korean guideline in 2013. We aimed to analyze the clinical characteristics of H. pylori -infected patients alongside their treatment protocols using a common data model (CDM). Materials and Methods: A 16-year electronic health record (of 1,689,604 patients from 2004 to 2019) was converted into a CDM in Kangdong Sacred Heart Hospital. We extracted records of patients who underwent the rapid urease test or serum anti- H. pylori IgG assay. The treatment protocols were visualized using a sunburst plot. We investigated the clinical characteristics and medication history of patients who underwent a urea breath test after clarithromycin-based eradication therapy. Results: Out of 29,458 patients tested for H. pylori infection, 7,647 received a treatment protocol. Among them, 72.5% received a 7~14 days protocol comprising a proton pump inhibitor (PPI), amoxicillin, and clarithromycin. The proportion of patients treated with the first-line protocol (PPI, bismuth, tetracycline, and metronidazole) slightly increased from 1.9% (before 2014) to 3.3% (after 2014) ( P <0.001). The percentages of patients with of previous exposure to macrolides (14.7% vs. 5.5%, P <0.001) or amoxicillin (10.6% vs. 7.3%, P =0.006) were higher in patients with previous clarithromycin-based eradication failure. Conclusions: The H. pylori treatment protocol was not significantly modified despite the updates in the clinical guideline. There was only 1.4 percentage point increase in bismuth-based quadruple therapy as first-line eradication therapy even after the announcement of revised Korean guideline in 2013. (Korean J Helicobacter Up Gastrointest Res 2022 Aug 19. [Epub print])","PeriodicalId":22895,"journal":{"name":"The Korean Journal of Helicobacter and Upper Gastrointestinal Research","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2022-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Clinical Characteristics and Treatment Pathway of Patients Treated with Helicobacter pylori Infection-A Single Center Cohort Study Using Common Data Model\",\"authors\":\"S. Seo, Tae Jun Kim, Y. J. Choi, C. S. Bang, Yong Kang Lee, M. Lee, S. Nam, W. Shin\",\"doi\":\"10.7704/kjhugr.2022.0010\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background/Aims: Changing trends in the Helicobacter pylori ( H. pylori ) eradication protocol have not been investigated after the publication of the third-revised Korean guideline in 2013. We aimed to analyze the clinical characteristics of H. pylori -infected patients alongside their treatment protocols using a common data model (CDM). Materials and Methods: A 16-year electronic health record (of 1,689,604 patients from 2004 to 2019) was converted into a CDM in Kangdong Sacred Heart Hospital. We extracted records of patients who underwent the rapid urease test or serum anti- H. pylori IgG assay. The treatment protocols were visualized using a sunburst plot. We investigated the clinical characteristics and medication history of patients who underwent a urea breath test after clarithromycin-based eradication therapy. Results: Out of 29,458 patients tested for H. pylori infection, 7,647 received a treatment protocol. Among them, 72.5% received a 7~14 days protocol comprising a proton pump inhibitor (PPI), amoxicillin, and clarithromycin. The proportion of patients treated with the first-line protocol (PPI, bismuth, tetracycline, and metronidazole) slightly increased from 1.9% (before 2014) to 3.3% (after 2014) ( P <0.001). The percentages of patients with of previous exposure to macrolides (14.7% vs. 5.5%, P <0.001) or amoxicillin (10.6% vs. 7.3%, P =0.006) were higher in patients with previous clarithromycin-based eradication failure. Conclusions: The H. pylori treatment protocol was not significantly modified despite the updates in the clinical guideline. There was only 1.4 percentage point increase in bismuth-based quadruple therapy as first-line eradication therapy even after the announcement of revised Korean guideline in 2013. (Korean J Helicobacter Up Gastrointest Res 2022 Aug 19. [Epub print])\",\"PeriodicalId\":22895,\"journal\":{\"name\":\"The Korean Journal of Helicobacter and Upper Gastrointestinal Research\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-08-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The Korean Journal of Helicobacter and Upper Gastrointestinal Research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.7704/kjhugr.2022.0010\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Korean Journal of Helicobacter and Upper Gastrointestinal Research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.7704/kjhugr.2022.0010","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Clinical Characteristics and Treatment Pathway of Patients Treated with Helicobacter pylori Infection-A Single Center Cohort Study Using Common Data Model
Background/Aims: Changing trends in the Helicobacter pylori ( H. pylori ) eradication protocol have not been investigated after the publication of the third-revised Korean guideline in 2013. We aimed to analyze the clinical characteristics of H. pylori -infected patients alongside their treatment protocols using a common data model (CDM). Materials and Methods: A 16-year electronic health record (of 1,689,604 patients from 2004 to 2019) was converted into a CDM in Kangdong Sacred Heart Hospital. We extracted records of patients who underwent the rapid urease test or serum anti- H. pylori IgG assay. The treatment protocols were visualized using a sunburst plot. We investigated the clinical characteristics and medication history of patients who underwent a urea breath test after clarithromycin-based eradication therapy. Results: Out of 29,458 patients tested for H. pylori infection, 7,647 received a treatment protocol. Among them, 72.5% received a 7~14 days protocol comprising a proton pump inhibitor (PPI), amoxicillin, and clarithromycin. The proportion of patients treated with the first-line protocol (PPI, bismuth, tetracycline, and metronidazole) slightly increased from 1.9% (before 2014) to 3.3% (after 2014) ( P <0.001). The percentages of patients with of previous exposure to macrolides (14.7% vs. 5.5%, P <0.001) or amoxicillin (10.6% vs. 7.3%, P =0.006) were higher in patients with previous clarithromycin-based eradication failure. Conclusions: The H. pylori treatment protocol was not significantly modified despite the updates in the clinical guideline. There was only 1.4 percentage point increase in bismuth-based quadruple therapy as first-line eradication therapy even after the announcement of revised Korean guideline in 2013. (Korean J Helicobacter Up Gastrointest Res 2022 Aug 19. [Epub print])