Helicobacter pylori Infection as a Risk Factor for Hospital-Acquired Upper Gastrointestinal Bleeding: A Prospective Observational Study

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 a prospective age- and gender-matched case-control study 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: 1.95, 95% CI: 1.15–3.30). Prolonged mechanical ventilation was also linked to UGIB (adjusted OR: 2.37, 95% CI: 1.20–4.67). Conclusions H. pylori infection, besides mechanical ventilator use, is an independent risk factor for UGIB in hospitalized patients. Early identification and targeted testing of the infection in nosocomial UGIB cases may prevent predictable complications.