Hospitalizations for Upper and Lower GI Events Associated With Traditional NSAIDs and Acetaminophen Among the Elderly in Quebec, Canada

Rahme, Elham; Barkun, Alan N.; Nedjar, Hacene; Gaugris, Sabine; Watson, Douglas J.

doi:10.1111/j.1572-0241.2008.01811.x

Cited by 119 publications

(82 citation statements)

References 27 publications

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“…With the use of published methodology, 5 exposure was defined to be 1.25×(number of days supplied) to extend exposure by a conservative grace period during which pharmacologically induced GI bleeding may occur. An individual would be considered off the CAT regimen, ie, time periods with no exposure, when that individual's longitudinal prescription-fill data did not demonstrate prescription of the drugs of interest.…”

Section: Assessment Of Drug Exposurementioning

confidence: 99%

Risk of Lower and Upper Gastrointestinal Bleeding, Transfusions, and Hospitalizations With Complex Antithrombotic Therapy in Elderly Patients

et al. 2013

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Background-Complex antithrombotic therapy (CAT) prescribed to elderly patients increases the risk of gastrointestinal bleeding. We quantified upper (UGIE) and lower gastrointestinal (LGIE) events, transfusions, and hospitalizations in a national cohort of elderly veterans prescribed CAT. Methods and Results-Veterans ≥60 years of age prescribed anticoagulant-antiplatelet, aspirin (ASA)-antiplatelet, ASAanticoagulant, or triple therapy (ie, TRIP, anticoagulant-antiplatelet-ASA) were identified from the national pharmacy database (October 1, 2002 to September 30, 2008. Prescription-fill data were linked to Veteran Affairs and Medicare encounter files, each person-day of follow-up was assessed for CAT exposure, and outcomes were defined by using diagnostic code algorithms derived following chart abstraction. Incidence density ratios (compared with the reference category of no CAT) and survival analysis was conducted. Among 78 133 veterans (98.6% white; mean age, 72.3 [standard deviation 7.7]), 64% were prescribed ASA-antiplatelet and anticoagulant-antiplatelet and 6% were prescribed TRIP. The incidence of UGIE was 20.1/1000 patient-years, and the incidence of LGIE was 70.1/1000 patient-years. ASA-anticoagulant and TRIP were associated with the highest incidence of transfusion and hospitalization. A 40% to 60% increased risk of UGIE was observed with all strategies.LGIE was 30% higher with anticoagulant-antiplatelet, and transfusion increased with ASA-anticoagulant (hazard ratio, 6.1; 95% confidence interval, 5.2-7.1) and TRIP (hazard ratio, 5.0; 95% confidence interval, 4.2-5.8). Increased risk of hospitalization was noted with all strategies. The number needed to harm for UGIE or LGIE ranged from 52 to 65 and 15 to 23, respectively. The number needed to harm for hospitalization was 39 (anticoagulant-antiplatelet), 34 (ASA-anticoagulant), 67 (ASA-antiplatelet), and 45 (TRIP) patients. Conclusions-Among

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Section: Assessment Of Drug Exposurementioning

confidence: 99%

Risk of Lower and Upper Gastrointestinal Bleeding, Transfusions, and Hospitalizations With Complex Antithrombotic Therapy in Elderly Patients

et al. 2013

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“…In our case, the finding of nonspecific inflammation in the cecum and ileocecal valve was thought to be related with the chronic usage of nonsteroidal antiinflammatory drugs (NSAIDs) over the previous year, because of the chronic abdominal pain. NSAIDs may lead to mucosal ulcerations, increased mucosal permeability and inflammation in the lower gastrointestinal tract (17). An autopsy study of more than 700 cases revealed that 8.4% of the chronic NSAID users had small bowel ulcers, while this ratio was 0.06% in nonusers (18).…”

Section: Discussionmentioning

confidence: 99%

A case of Meckel’s diverticulitis treated on the assumption of Crohn’s disease

Enç¹,

Yorulmaz²,

Melikoglu³

et al. 2010

Turk J Gastroenterol

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“…Otuz günlük tekrar kanama inisiyal endoskopik hemostazda baflar›s›zl›k ve ciddi ko-morbidite ile iliflkili bulunmufltur (13). Ko-morbidite ile mortalite aras›ndaki iliflki di¤er çal›flmalarda da gösteril-mifltir (14,15).…”

Section: G‹r‹fiunclassified

Varis dışı üst gastrointestinal sistem kanamalı hastaların demografik ve klinik özellikleri

BAHADIR¹,

Yalnız²,

Demirel³

et al. 2015

Endoskopi Gastrointestinal

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G‹R‹fiVaris d›fl› üst gastrointestinal sistem kanamalar› (VDÜGK) gastrointestinal sistemin en s›k karfl›lafl›lan acil sa¤l›k problemlerindendir. H 2 reseptör antagonistlerin yetmiflli y›llar›n ortas›nda bulunmas› ve proton pompa inhibitörleri (PP‹)'nin seksenli y›llar›n sonunda bulunmas›yla ülser komplikasyonlar›n› önleme, tekrar kanamay› azaltma ve ülser iyileflmesini sa¤lama olanaklar› do¤mufltur. Ayr›ca Helikobakter pylori (Hp) enfeksiyonunun peptik ülser gelifliminde rolü oldu¤u ve eradikasyonunun ülser kanama tekrar›n› önledi¤i görülmüfl-tür. Endoskopik olanaklar›n kanama nedenini belirlemesi ve tedavi flans›n› sa¤lamas›na ra¤men toplumun yafllanmas› daha fazla komorbidite ve ilaç kullan›m›na yol açt›¤›ndan halen VDÜGK önemli sa¤l›k problemlerindendir.Üst gastrointestinal sistem (G‹S) kanamas› s›k olup 100binde 50-150 kiflide görülmektedir. Erkeklerde ve yafll›larda daha s›k rastlanmaktad›r (1-3). Varis d›fl› akut üst G‹S kanamalar en s›k peptik ülsere ba¤l›d›r (4). Bunun d›fl›nda anjiyomalar, Mallory Weiss y›rt›¤›, tümörler, erozyonlar, dieulafoy lezyon- 3) 24 saat sonras›nda yap›lm›flt›r. 84 (%25.5) hastaya en s›k (%88.1) adrenalin enjeksiyonu olmak üzere endoskopik tedavi uygulanm›flt›r. Hastalar›n 122'sine (%37) üreaz testi yap›lm›fl, 107'sinde (%87) Helikobakter pozitif olarak bulunmufl. ‹lk 12 saatte 0.81±1.0, totalde 1.8±2.1 eritrosit süspansiyonu verilmifltir. En s›k rastlanan kanama nedenleri; 257'de (%77.9) peptik ülser, 119'da (%36.1) mide ülseri, 138'de (%41.8) duodenal ülser) ve erozif gastrittir (n=203, %61.5). Rockall skorlamas›na göre 61 (%18.5) hasta düflük risk, 260 (%78.8) hasta orta risk ve 9 (%2.7) hasta yük-sek riskliydi. Forrest evrelemesine göre ço¤u evre 3 ülsere sahipti (n=153, %40.9). Evre 2B ülserlerse mortaliteyle pozitif koreleydi. 7 hastaya (%2.1) cerrahi tedavi gerekti, 6's›nda (%1.8) ölüm gerçekleflti. Sonuç: Varis d›fl› üst gastrointestinal kanama erkeklerde ve yafll›larda daha s›k görülmekte olup en s›k nedeni peptik ülserdir. Yar›s›ndan fazlas›nda nonsteroid anti-inflamatuvar ilaç ve aspirin kullan›m› risk faktörü olarak saptand›. Mortalite, cerrahi ve eritrosit süspansiyon replasman› ihtiyac› oldukça düflük saptand›. Bunun nedeni erken (ilk 24 saat) endoskopik inceleme ve müdahalenin yüksek oranda olmas›ndan kaynaklanabilir. Anahtar kelimeler: Varis d›fl› üst gastrointestinal kanama, etyoloji, endoskopiBackground and Aims: Non-variceal upper gastrointestinal bleeding (NVUGB) is one of the most frequent emergencies. The aim of the present study was to determine the demographic and clinical features of NVUGB patients. Materials and methods: Patients with NVUGB admitted between 2005-2010 years examined with endoscopy were evaluated retrospectively in terms of demographical characteristics, etiological risk factors, treatment modalities and mortality. Results: Mean age of 228 (%77) male and 120 (%23) female was 59, 9 (17-99). 84 (%25.5) of the patients were smoking, 12 (%7) were drinking alcohol, 292 (%88.5) were using drug (148/292 (%44.8) nonsteroidal anti-inflammatory dru...

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Hospitalizations for Upper and Lower GI Events Associated With Traditional NSAIDs and Acetaminophen Among the Elderly in Quebec, Canada

Abstract: Among elderly patients requiring analgesic/anti-inflammatory treatment, use of the combination of a tNSAID and acetaminophen may increase the risk of GI bleeding compared with either agent alone.

Cited by 119 publications

References 27 publications

Risk of Lower and Upper Gastrointestinal Bleeding, Transfusions, and Hospitalizations With Complex Antithrombotic Therapy in Elderly Patients

Risk of Lower and Upper Gastrointestinal Bleeding, Transfusions, and Hospitalizations With Complex Antithrombotic Therapy in Elderly Patients

A case of Meckel’s diverticulitis treated on the assumption of Crohn’s disease

Varis dışı üst gastrointestinal sistem kanamalı hastaların demografik ve klinik özellikleri

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