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Related Experiment Videos

Assessing and understanding patient risk.

J F Fries1

  • 1Division of Immunology and Rheumatology, Stanford University School of Medicine, Palo Alto, California 94304.

Scandinavian Journal of Rheumatology. Supplement
|January 1, 1992
PubMed
Summary
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Nonsteroidal anti-inflammatory drug (NSAID) gastropathy causes thousands of deaths and hospitalizations annually. Identifying high-risk patients using factors like age and prior side effects can guide treatment decisions for serious gastrointestinal events.

Area of Science:

  • Rheumatology
  • Gastroenterology
  • Pharmacology

Background:

  • Nonsteroidal anti-inflammatory drug (NSAID) gastropathy is a significant cause of morbidity and mortality in the United States.
  • NSAID-associated gastropathy leads to an estimated 7600 deaths and 76000 hospitalizations yearly.
  • Rheumatoid arthritis patients have a 1.6% hospitalization rate due to NSAID gastropathy, with osteoarthritis patients showing a lower incidence.

Purpose of the Study:

  • To identify key risk factors for serious gastrointestinal (GI) events in patients using NSAIDs.
  • To develop an algorithm for estimating the 12-month risk of serious GI events.
  • To aid in identifying high-risk patients and guiding therapeutic decisions.

Main Methods:

  • Prospective follow-up of 3000 rheumatoid arthritis patients for an average of five years using the Arthritis, Rheumatism and Aging Medical Information System (ARAMIS).

Related Experiment Videos

  • Multivariate analyses were conducted on 1694 rheumatoid arthritis patients taking NSAIDs to assess risk factors for serious GI events.
  • An algorithm was developed incorporating identified risk factors to predict 12-month risk.

    • Main Results:

    • Key risk factors for serious GI events include older age, prednisone use, previous NSAID-related GI side effects, prior GI hospitalization, functional disability, and NSAID dose.
    • These variables form the basis of an algorithm to estimate the risk of a serious GI event within the next 12 months.
    • The study provides a tool for risk stratification in NSAID users.

    Conclusions:

    • Understanding the interrelationships of risk factors is crucial for managing NSAID gastropathy.
    • The developed algorithm can identify patients at high risk for serious GI events.
    • This knowledge supports informed therapeutic decisions to mitigate NSAID-related gastrointestinal complications.