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Risk of hospitalization resulting from upper gastrointestinal bleeding among patients taking corticosteroids: a

G L Nielsen1, H T Sørensen, L Mellemkjoer

  • 1Department of Clinical Epidemiology at Aarhus University Hospitals, Aarhus, Denmark.

The American Journal of Medicine
|November 14, 2001
PubMed

Insights

Systemic corticosteroid use significantly increases upper gastrointestinal bleeding hospitalization risk. This risk is higher when combined with other medications, highlighting the need for careful patient monitoring.

Area of Science:

  • Gastroenterology
  • Pharmacology
  • Epidemiology

Background:

  • Systemic corticosteroids are widely prescribed for various inflammatory and autoimmune conditions.
  • Concurrent use of other medications can potentially modify the gastrointestinal safety profile of corticosteroids.

Purpose of the Study:

  • To evaluate the association between systemic corticosteroid use and the risk of hospitalization for upper gastrointestinal bleeding.
  • To assess the impact of concomitant medications on this risk.

Main Methods:

  • Population-based cohort study utilizing prescription and hospital discharge data from North Jutland County, Denmark (1991-1995).
  • Comparison of observed upper gastrointestinal bleeding hospitalizations among corticosteroid users against expected rates in the general population.

Main Results:

  • A total of 45,980 patients were included, with 18,379 person-years of corticosteroid exposure.
  • Corticosteroid users had a 4.2-fold increased risk of upper gastrointestinal bleeding hospitalization (95% CI: 3.4-5.0).
  • The risk was elevated (2.9-fold) even without other associated drugs and reduced with former versus current use (1.9-fold).

Conclusions:

  • Systemic corticosteroid therapy is associated with a significantly increased risk of upper gastrointestinal bleeding hospitalization.
  • Concomitant medication use amplifies this risk, underscoring the importance of medication review.
  • Potential confounding by the underlying disease necessitating corticosteroid treatment may also contribute to the observed association.
Abstract

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