Objective:

To determine whether the endoscopic grade of gastric atrophy affects the likelihood of successful first-line H. pylori eradication.

Approach:

Key Findings:

• Overall eradication rate was 76.6% (118/154).
• Eradication rate in open-type atrophy group was 42.3% (11/26), significantly lower than 83.6% (107/128) in closed-type group (P < 0.001).
• Open-type atrophy was independently associated with eradication failure (OR = 8.287, P < 0.001).

Interpretation:

Limitations:

• Single-center study may limit generalizability.
• Retrospective design may introduce selection bias.

Conclusion:

For patients with Kimura-Takemoto open-type atrophy, alternative regimens or individualized therapy should be considered.

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