UPPER GASTROINTESTINAL TRACT HEMORRHAGE AND NONSTEROIDALANTIINFLAMMATORY DRUGS (NSAIDs) – A 5-YEAR PROSPECTIVE STUDY

  • Pavel Skok Oddelek za gastroenterologijo in endoskopijo Klinični oddelek za interno medicino Splošna bolnišnica Maribor Ljubljanska ul. 5 2000 Maribor
  • Marija Skok Zdravstveni dom Maribor Ul. talcev 5 2000 Maribor
Keywords: gastrointestinal tract hemorrhage, nonsteroidal antiinflammatory drugs (NSAIDs), adverse effects, complications, mortality

Abstract

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

Downloads

Download data is not yet available.

References

Skok P. Incidenca krvavitev iz zgornje prebavne cevi – 5-letna prospektivna študija. Zdrav Vestn 2000; 69: 727–31.

Križman I. Krvavitve iz prebavne cevi – epidemiologija. In: Bručan A, Gričar M eds. Urgentna medicina – Izbrana poglavja. Ljubljana 1995: 7–14.

Skok P. The epidemiology of hemorrhage from the upper gastrointestinal tract in the mid-nineties – has anything changed? Hepatogastroenterology 1998; 24: 2228–33.

Skok P. How efficient is endoscopic injection sclerotherapy in peptic ulcer hemorrhage? Hepatogastroenterology 1997; 15: 861–5.

Skok P, Sinkovič A, Ćeranić D, Pocajt M. Peptic ulcer bleeding in intensive care unit (ICU): a prospective, controlled, randomized study. Critical Care 2001; 5: Suppl 1: S65–5.

Skok P, Ćeranić D, Sinkovič A, Pocajt M. Peptic ulcer hemorrhage: Argon plasma coagulation versus injection sclerotherapy. Verdauungskrankheiten 2001; 19: 107–13.

Molj J, Ivanuša M, Drinovec J, Mrhar A. Nekateri epidemiološki vidiki ulkusne bolezni v Sloveniji. Zdrav Vestn 1998; 67: 697–701.

Cook DJ, Guyatt GH, Salena BJ et al. Endoscopic therapy for acute nonvariceal upper gastrointestinal haemorrhage: A meta-analysis. Gastroenterology 1992; 102: 139–48.

Gupta PK, Fleischer D. Endoscopic hemostasis in non-variceal bleeding. Endoscopy 1994; 26: 48–54.

Ell C. Komplikationen des peptischen Ulkus. In: Hahn EG, Riemann JF eds. Klinische Gastroenterologie. Stuttgart: Georg Thieme Verlag, 1996; 785–97.

Kurata JH, Haile BM. Epidemiology of peptic ulcer disease. Clin Gastroenterol 1984; 13: 145–57.

Rockall TA, Logan RFA, Devlin HB, Northfield TC. Incidence of and mortality from upper gastrointestinal haemorrhage in the United Kingdom. BMJ 1995; 311: 226–30.

Katz J. The clinical course of peptic ulcer disease. Med Clin North Am 1991; 75: 831–40.

Kreiss C, Blum AL. Epidemiology and risk factors of gastroduodenal ulcer. Chirurg 1996; 67: 7–13.

Sonnenberg A, Everhart JE. Health impact of peptic ulcer in the United States. Am J Gastroenterol 1997; 92: 614–20.

Fock KM. Peptic ulcer disease in the 1990s: an Asian perspective. J Gastroenterol Hepatol 1997; 12: S23–8.

Kurata JH, Nogawa AN. Meta-analysis of risk factors for peptic ulcer. Nonsteroidal antiinflammatory drugs, Helicobacter pylori and smoking. J Clin Gastroenterol 1997; 24: 2–17.

Graham DY. Nonsteroidal anti-inflammatory drugs, Helicobacter pylori, and ulcers: Where we stand. Am J Gastroenterol 1996; 91: 2080–6.

Hudson N. Excess long-term mortality in patients with ulcer complications. Lancet 1997; 349: 968–9.

Gutthann SP, Garcia Rodriguez LA, Raiford DS. Individual nonsteroidal antiinflammatory drugs and other risk factors for upper gastrointestinal bleeding and perforation. Epidemiology 1997; 8: 18–24.

Wilcox CM, Clark WS. Features associated with painless peptic ulcer bleeding. Am J Gastroenterol 1997; 92: 1289–92.

Meier R, Wettstein AR. Treatment of acute nonvariceal upper gastrointestinal hemorrhage. Digestion 1999; 60: Suppl 2: 47–52.

Griffin MR. Epidemiology of nonsteroidal anti-inflammatory drug-associated gastrointestinal injury. Am J Med 1998; 104 (3A): 23S–29S.

Henry D, Lim LY, Garcia Rodriguez LA et al. Variability in risk of gastrointestinal complications with individual non-steroidal anti-inflammatory drugs: results of a collaborative meta-analysis. BMJ 1996; 12: 1563–6.

Fürst J, Samaluk V. Predpisovanje zdravil na recept v letu 1999. Racionalna farmakoterapija 2000; 4: 4–7.

Bagari N. Recepti v Sloveniji v letu 1999. Racionalna farmakoterapija 2000; 4: 8–16.

Fürst J, Samaluk V. Predpisovanje protivnetnih in protibolečinskih zdravil v Sloveniji v letu 1999. Racionalna farmakoterapija 2000; 6: 20–2.

How to Cite
1.
Skok P, Skok M. UPPER GASTROINTESTINAL TRACT HEMORRHAGE AND NONSTEROIDALANTIINFLAMMATORY DRUGS (NSAIDs) – A 5-YEAR PROSPECTIVE STUDY. ZdravVestn [Internet]. 1 [cited 22Nov.2019];71(3). Available from: https://vestnik.szd.si/index.php/ZdravVest/article/view/1574
Section
Professional Article