{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T15:01:18Z","timestamp":1793977278849,"version":"4.8.0"},"reference-count":36,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,5,6]],"date-time":"2021-05-06T00:00:00Z","timestamp":1620259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>With the increasing use of medications that alter the risk of gastrointestinal bleeding (GIB), comprising aspirin, proton pump inhibitors (PPIs), and <jats:italic>Helicobacter pylori<\/jats:italic> eradication therapies, the trends of GIB are evolving.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The aim of this study is to determine and predict the trends of GIB and to evaluate the effects of population prescriptions of these medications on GIB incidences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrieved patients hospitalized for GIB in all public hospitals in Hong Kong between 2009 and 2019. Monthly age\u2010 and sex\u2010standardized GIB data were fitted and predicted, based on population prescriptions of aspirin, nonsteroidal anti\u2010inflammatory drugs (NSAIDs), anticoagulants, other antiplatelet drugs, PPIs, and <jats:italic>H. pylori<\/jats:italic> therapies, using autoregressive integrated moving average model for time series analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The incidence of upper GIB (UGIB) showed a clear declining trend while lower GIB (LGIB) decreased slightly. Older population (&gt;80 years) had the greatest decline in UGIB but was associated with an increase in LGIB. Prescriptions of PPIs and aspirin increased significantly with time. PPIs prescriptions were negatively associated with UGIB incidence (coefficient log(PPIs) \u22124.58; 95% confidence interval [CI]: \u22125.69, \u22123.47). <jats:italic>H. pylori<\/jats:italic> eradication in the previous month showed a nonsignificant trend on UGIB (coefficient \u22120.14; 95% CI: \u22120.30, 0.02). In contrast, aspirin increased the incidences of UGIB (coefficient 0.06; 95% CI: 0.04, 0.07) and LGIB (coefficient 0.04; 95% CI: 0.03, 0.05). NSAIDs, anticoagulants, and other antiplatelet drugs were not significantly associated with the trend of either UGIB or LGIB. UGIB is predicted to decline continuously but LGIB is projected to rise, particularly with increasing use of aspirin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>UGIB incidences were decreasing and had been surpassed by LGIB. Based on population prescriptions of aspirin and PPIs, divergent trends of upper and lower GIB are expected, especially in elderly.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ueg2.12067","type":"journal-article","created":{"date-parts":[[2021,5,7]],"date-time":"2021-05-07T16:05:04Z","timestamp":1620403504000},"page":"543-551","source":"Crossref","is-referenced-by-count":24,"title":["Divergent trends of hospitalizations for upper and lower gastrointestinal bleeding based on population prescriptions of aspirin, proton pump inhibitors and <i>Helicobacter pylori<\/i> eradication therapy"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0657-473X","authenticated-orcid":false,"given":"Chuan\u2010Guo","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Medicine Li Ka Shing Faculty of Medicine, University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3718-243X","authenticated-orcid":false,"given":"Feifei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Usher Institute University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3155-5987","authenticated-orcid":false,"given":"Joseph T.","family":"Wu","sequence":"additional","affiliation":[{"name":"School of Public Health Li Ka Shing Faculty of Medicine, University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4838-378X","authenticated-orcid":false,"given":"Ka\u2010Shing","family":"Cheung","sequence":"additional","affiliation":[{"name":"Department of Medicine Li Ka Shing Faculty of Medicine, University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bofei","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Esophageal and Upper Gastrointestinal Surgery, Department of Surgery Li Ka Shing Faculty of Medicine, University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6518-5806","authenticated-orcid":false,"given":"Simon Y. 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