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Risk factors for gastrointestinal bleeding: a hospital-based case-control study.
Priska Vonbach1, Rahel Reich, Friedrich Möll
1Hospital Pharmacy, Kantonsspital Winterthur / University Children's Hospital Zurich, Switzerland.
Swiss Medical Weekly
|January 17, 2008
Summary
First-time gastrointestinal (GI) bleeding is linked to high International Normalized Ratio (INR) values and drug-drug interactions (DDIs). Combining NSAIDs with glucocorticoids or oral anticoagulants significantly increases GI bleeding risk.
Area of Science:
- Pharmacovigilance
- Gastroenterology
- Internal Medicine
Background:
- Gastrointestinal (GI) bleeding is a serious adverse drug reaction.
- Identifying risk factors for first-time GI bleeding is crucial for patient safety.
Purpose of the Study:
- To investigate risk factors for first-time GI bleeding leading to hospital admission.
- To focus on the role of specific drugs and drug-drug interactions (DDIs).
Main Methods:
- A hospital-based case-control study was conducted.
- 74 patients with first-time GI bleeding and 148 controls were included.
- Matching was performed for age, sex, and calendar time.
Main Results:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) and thrombocyte aggregation inhibitors were significant risk factors.
- High International Normalized Ratio (INR) values (> or = 4) increased bleeding risk.
- Combined use of NSAIDs with glucocorticoids or oral anticoagulants showed substantially elevated risk estimates.
Conclusions:
- Well-controlled oral anticoagulation alone was not associated with GI bleeding.
- High INR values, but not therapeutic anticoagulation, were linked to bleeding.
- Combinations of NSAIDs with glucocorticoids or oral anticoagulants pose a high risk for GI bleeding.
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