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Nonsteroidal anti-inflammatory drugs, arthritis, and gastrointestinal bleeding in elderly in-patients
Insights
Nonsteroidal anti-inflammatory drugs (NSAIDs) are closely linked to upper gastro-intestinal bleeding in elderly patients. Simple analgesics like paracetamol are recommended for osteoarthritis pain management in seniors.
Area of Science:
- Geriatric Medicine
- Gastroenterology
- Pharmacology
Background:
- Elderly patients are susceptible to adverse drug events.
- Upper gastro-intestinal (UGI) bleeding is a significant concern in geriatric admissions.
Purpose of the Study:
- To investigate the incidence of UGI bleeding in an acute geriatric unit.
- To examine the relationship between NSAID use and UGI bleeding in the elderly.
Main Methods:
- Prospective study of 531 consecutive admissions to a geriatric unit.
- Diagnosis of UGI bleeding.
- Analysis of medication use, particularly NSAIDs.
Main Results:
- 33 cases of UGI bleeding were diagnosed.
- A strong association was found between NSAID use and UGI bleeding.
- Many elderly patients used NSAIDs for analgesia rather than anti-inflammatory purposes.
Conclusions:
- NSAID use poses a significant risk for UGI bleeding in the elderly.
- Paracetamol is recommended as a safer alternative for osteoarthritis maintenance therapy.
- NSAIDs should be reserved for treating true arthritis in selected elderly patients.
Abstract:
In a study of 531 consecutive admissions to an acute geriatric admitting unit in England in a four-month period, 33 cases of upper gastro-intestinal (UGI) bleeding were diagnosed. There was a close relationship between UGI bleeding and the use of nonsteroidal anti-inflammatory drugs (NSAIDs), and it is argued that this is a causal link. In view of the dangers of NSAID ingestion by elderly patients, many of whom are using them for analgesic rather than anti-inflammatory reasons, it is suggested that simple analgesics such as paracetamol should be used for maintenance therapy of osteoarthritis in the elderly, with NSAIDs being reserved for treatment of true arthritis in selected patients.