{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T20:42:48Z","timestamp":1774039368713,"version":"3.50.1"},"reference-count":19,"publisher":"Maad Rayan Publishing Company","issue":"4","content-domain":{"domain":["jrhs.umsha.ac.ir"],"crossmark-restriction":false},"short-container-title":["J Res Health Sci"],"published-print":{"date-parts":[[2023,12,29]]},"abstract":"<jats:p>Background: Hospitalization for peptic ulcer disease (PUD) has been described outside of North America as peaking in the fall and winter. However, no recent literature has so far investigated the seasonal fluctuations and complications of PUD in the USA. Study Design: Cross-sectional population database review. Methods: Patients with a diagnosis of either acute gastric or acute duodenal ulcers from January 1, 2015, through December 31, 2017, were identified in the Healthcare Cost and Utilization Project\u2019s National Inpatient Sample. The proportion of admissions with either hemorrhage or perforation was determined for each season and further subdivided into geographic regions. Results: Of 18829 hospitalizations for PUD, admissions were the highest in the fall (25.9%) while being the lowest in the summer (23.9%). Complications, hemorrhage or perforation, were the highest and the lowest in the fall and spring, respectively (75.7% vs. 73.6%; P=0.060 for comparing all 4 seasons). Geographically, the West had the highest rate of peptic ulcer hemorrhage (64.5%, P=0.004), while the northeast had the highest rate of perforation (14.3%, P=0.003). Hemorrhage was more common in males, those who used aspirin, nonsteroidal anti-inflammatory drugs, or anticoagulants, and diabetics (P&lt;0.05). Perforation was less common in males, those with diabetes, obesity, or hypertension (HTN), or those using aspirin or anticoagulants (P&lt;0.05). Helicobacter pylori infection was more associated with perforation in the fall and winter months. Conclusion: Seasonal and regional trends in hospitalizations due to PUD may help identify modifiable risk factors, which can improve diagnostic and treatment outcomes for patients by allowing for more targeted identification of vulnerable populations. <\/jats:p>","DOI":"10.34172\/jrhs.2023.130","type":"journal-article","created":{"date-parts":[[2023,12,30]],"date-time":"2023-12-30T11:53:05Z","timestamp":1703937185000},"page":"e00595","update-policy":"https:\/\/doi.org\/10.34172\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Seasonal and Geographic Variation in Peptic Ulcer Disease and Associated Complications in the United States of America"],"prefix":"10.34172","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0512-4489","authenticated-orcid":true,"given":"Kausthubha","family":"Yaratha","sequence":"first","affiliation":[{"name":"Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindsay","family":"Talemal","sequence":"additional","affiliation":[{"name":"Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian V.","family":"Monahan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Temple University Hospital, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daohai","family":"Yu","sequence":"additional","affiliation":[{"name":"Center for Biostatistics and Epidemiology, Department of Biomedical Education and Data Science, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoning","family":"Lu","sequence":"additional","affiliation":[{"name":"Center for Biostatistics and Epidemiology, Department of Biomedical Education and Data Science, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Lucas","family":"Poggio","sequence":"additional","affiliation":[{"name":"Department of Surgery, Temple University Hospital, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"20123","published-online":{"date-parts":[[2023,12,29]]},"reference":[{"key":"R1","unstructured":"OMICS International. Peptic Ulcer. 2023. Available from: https:\/\/www.omicsonline.org\/ulcer-disease.php. Updated October 2023. Accessed October 12, 2023."},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2009.03960.x"},{"key":"R3","unstructured":"Vakil N. Overview of complications of peptic ulcer disease. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate; 2020."},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13682"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000025820"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.1186\/1471-230x-10-37"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.3892\/etm.2014.2080"},{"key":"R8","first-page":"731","article-title":"Seasonal variation in the frequency of Helicobacter pylori infection: a possible cause of the seasonal occurrence of peptic ulcer disease","volume":"89","author":"Moshkowitz M","year":"1994","journal-title":"Am J Gastroenterol"},{"key":"R9","unstructured":"Agency for Healthcare Research and Quality. Overview of the National (Nationwide) Inpatient Sample (NIS). Healthcare Cost and Utilization Project website. Available from: http:\/\/www.hcup-us.ahrq.gov\/nisoverview.jsp. Accessed February 8, 2021."},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.1080\/07420528709078512"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.19618"},{"key":"R12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.1984.tb06686.x"},{"key":"R13","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyz273"},{"key":"R14","unstructured":"Centers for Disease Control and Prevention. National and State Diabetes Trends. CDC. Available from: https:\/\/www.cdc.gov\/diabetes\/library\/reports\/reportcard\/national-state-diabetes-trends.html. Updated May 17, 2022. Accessed October 12, 2023."},{"key":"R15","unstructured":"Centers for Disease Control and Prevention. Hypertension. CDC. Available from: https:\/\/www.cdc.gov\/nchs\/fastats\/hypertension.htm. Updated September 19, 2023. Accessed October 12, 2023."},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.3390\/nu11061288"},{"key":"R17","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.29.04.06.dc05-1748"},{"key":"R18","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2011-300186"},{"key":"R19","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2018.08.025"}],"container-title":["Journal of Research in Health Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jrhs.umsha.ac.ir\/PDF\/8672.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/jrhs.umsha.ac.ir\/PDF\/8672.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T05:13:46Z","timestamp":1704863626000},"score":1,"resource":{"primary":{"URL":"https:\/\/jrhs.umsha.ac.ir\/Article\/jrhs-8672"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,29]]},"references-count":19,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,12,29]]},"published-print":{"date-parts":[[2023,12,29]]}},"URL":"https:\/\/doi.org\/10.34172\/jrhs.2023.130","relation":{},"ISSN":["2228-7795","2228-7809"],"issn-type":[{"value":"2228-7795","type":"print"},{"value":"2228-7809","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,29]]},"assertion":[{"value":"Hamadan University of Medical Sciences","name":"journal_owner","label":"Journal Owner"},{"value":"Hamadan University of Medical Sciences","name":"journal_publisher","label":"Journal Publisher"},{"value":"2023-06-15","order":1,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}