UPPER GASTROINTESTINAL TRACT HEMORRHAGE AND NONSTEROIDALANTIINFLAMMATORY DRUGS (NSAIDs) – A 5-YEAR PROSPECTIVE STUDY
Background. Adverse effects of nonsteroidal antiinflammatory drugs (NSAIDs) are a common cause of digestive tract hemorrhage.
Study aims. The purpose of the study was to ascertain the percent of patients taking NSAIDs with upper digestive tract hemorrhage.
Type of study. Prospective, analytical.
Patients and methods. The study includes patients in which urgent endoscopic investigations of the upper digestive tract were carried out due to gastrointestinal hemorrhage between 1 January 1994 and 31 December 1998.
Results. 3366 patients were investigated: 1222 women and 2144 men; the average age of our patients was 57.5 years (SD ± 17.1, a 2–97 year span). In 2905 patients (86.3%) the source of bleeding was confirmed in the upper gastrointestinal tract. Among our patients 55% were aged over 60 years, 26.7% were older than 80 years. Sequelae of peptic ulcer disease were the most significant cause of gastrointestinal hemorrhage, in 47.7% of our patients (1387/2905). In the last week prior to bleeding, 19% of patients (552/2905) were taking regularly NSAIDs, corticosteroids, salycilates or anticoagulant therapy at least in single daily dose. The majority of patients, 94.5%, were taking NSAIDs or salycilates. Among NSAIDs they were taking most often ketoprofen, diclofenac or naproxen/ naproxen natrium, less often ibuprofen, nabumeton, etodolac or piroxicam.
Conclusions. Upper digestive tract hemorrhage is a serious complication of NSAIDs medication, particularly in older patients
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