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Proton pump inhibitors (PPIs) reduce stomach acid, which is needed for B12 absorption
The authors made the following conclusion: Omeprazole (PPI) therapy acutely decreased cyanocobalamin (B12) absorption in a dose-dependent manner.[191] B12 absorption issues worsen in patients with atrophic gastritis, which is a common condition in the elderly
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The measure is not risk-adjusted because the numerator events are considered access failures regardless of ( patient acuity or clinical comorbidity
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