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Hospitalisation for upper gastrointestinal bleeding associated with use of oral anticoagulants

S P Johnsen1, H T Sørensen, L Mellemkjoer

  • 1Department of Epidemiology and Social Medicine, University of Aarhus, Denmark. spj@soci.au.dk

Thrombosis and Haemostasis
|August 28, 2001
PubMed

Insights

Oral anticoagulants (OA) significantly increase the risk of upper gastrointestinal (GI) bleeding. Combining OA with other medications, such as acetaminophen, further elevates this risk, necessitating further research.

Area of Science:

  • Pharmacovigilance
  • Gastroenterology
  • Public Health

Background:

  • Oral anticoagulants (OA) are widely prescribed medications.
  • Upper gastrointestinal (GI) bleeding is a serious adverse event.
  • Concomitant use of multiple medications is common in patients on OA.

Purpose of the Study:

  • To investigate the incidence of upper GI bleeding hospitalizations among OA users.
  • To compare the risk of GI bleeding in OA users versus the general population.
  • To assess the impact of combining OA with other drugs on GI bleeding risk.

Main Methods:

  • Cohort study utilizing Danish prescription and hospital discharge data.
  • Inclusion of 4,204 oral anticoagulant users.
  • Standardized incidence ratio (SIR) calculation for risk assessment.

Main Results:

  • OA use was associated with a 2.8-fold increased risk of upper GI bleeding (SIR = 2.8).
  • Combined use of OA with acetaminophen, NSAIDs, or corticosteroids showed higher SIRs.
  • Acetaminophen (SIR = 4.4), non-aspirin NSAIDs (SIR = 8.0), and aspirin/corticosteroids (SIR = 3.8) demonstrated elevated risks.

Conclusions:

  • Oral anticoagulant therapy significantly elevates the risk of upper GI bleeding.
  • Concomitant medication use, particularly with acetaminophen, amplifies this risk.
  • Further research is required to elucidate drug interaction mechanisms and clinical implications for GI bleeding.

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