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[Upper gastrointestinal hemorrhage caused by anti-inflammatory agents]
C Duhamel1, P Czernichow, P Dechelotte
1Groupe de Biochimie et de Physiopathologie Digestive et Nutritionnelle, Rouen.
Gastroenterologie Clinique Et Biologique
|March 1, 1989
Summary
Nonsteroidal anti-inflammatory drugs (NSAIDs) increase gastroduodenal bleeding risk, with aspirin linked to more gastric lesions and less need for surgery. Other NSAIDs without salicylates were used more by older females for osteoarthritis.
Area of Science:
- Gastroenterology
- Pharmacology
- Internal Medicine
Background:
- Upper gastrointestinal bleeding is a significant clinical concern.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used for pain and inflammation.
- NSAID use is associated with an increased risk of gastroduodenal complications.
Purpose of the Study:
- To characterize the clinical and evolutive aspects of gastroduodenal bleeding in patients using NSAIDs (with or without salicylates).
- To compare the relative toxicity of NSAIDs without salicylates versus other anti-inflammatory therapies.
- To identify patient demographics and lesion characteristics associated with NSAID-induced bleeding.
Main Methods:
- Retrospective analysis of 845 consecutive patients with upper gastrointestinal bleeding admitted to an intensive care unit.
- Classification of patients based on anti-inflammatory drug use: NSAIDs without salicylates, salicylates, steroids, or no anti-inflammatory therapy.
- Comparison of clinical parameters including lesion type, concomitant therapies, need for surgery, and mortality.
Main Results:
- Of 267 patients on anti-inflammatory drugs, 151 used NSAIDs without salicylates and 97 used salicylates.
- Patients on NSAIDs without salicylates were older and more frequently female compared to other groups.
- Aspirin use was associated with a higher percentage of gastric lesions and a lower need for surgical hemostasis.
Conclusions:
- NSAIDs, including those with and without salicylates, are associated with upper gastrointestinal bleeding.
- NSAIDs without salicylates were more frequently prescribed to older females, often for osteoarthritis.
- While aspirin use showed specific patterns in lesion type and surgical intervention, overall mortality and need for surgery did not significantly differ between NSAID groups.