Time trends and outcome of gastrointestinal bleeding in the Veneto Region: A retrospective population based study from 2001 to 2010

Cavallaro, L.G.; Monica, Fabio; Germanà, B.; Marin, R.; Sturniolo, Giacomo Carlo; Saïa, Mario

doi:10.1016/j.dld.2013.11.005

Cited by 29 publications

(46 citation statements)

References 21 publications

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“…It has been suggested that the decreases in PUD and UGIB are caused by an overall decrease in H pylori prevalence in addition to an increased use of acid-suppressing medications. 36,40,41 Although UGIB and peptic ulcer bleeding are decreasing in the general population overall, rates of hospitalization because of ulcer complications are increasing in elderly populations. 42 This paradoxic observation is thought to be caused by longer life expectancy in Western countries leading to increased occurrences of cardiovascular and rheumatic diseases that are associated with an increased use of aspirin and NSAIDs among the elderly population.…”

Section: Worldwide/regional Incidencementioning

confidence: 99%

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Epidemiology and Risk Factors for Upper Gastrointestinal Bleeding

Tielleman

Bujanda

Cryer³

2015

Gastrointestinal Endoscopy Clinics of North America

121

101

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Section: Worldwide/regional Incidencementioning

confidence: 99%

“…3,24,[36][37][38][39] The variability in incidence rates is mainly caused by the variance of methodology used in diagnosing UGIB. However, despite this limitation, the information corroborates decreasing incidence of UGIB all over the world.…”

Section: Worldwide/regional Incidencementioning

confidence: 99%

Epidemiology and Risk Factors for Upper Gastrointestinal Bleeding

Tielleman

Bujanda

Cryer³

2015

Gastrointestinal Endoscopy Clinics of North America

121

101

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“…It is increasingly recognized that the small bowel, like the stomach, is a site for NSAID-associated mucosal lesions, giving rise to NSAID-enteropathy [ 38 ]. Over the last 10 years, there has been a decreasing trend in NSAID-induced symptomatic GI events in rheumatic patients [ 39 ] and, in line with that, in hospitalizations due to upper GI complications, while lower GI complications showed an apparent increasing trend [ 40 - 43 ]. In addition, the clinical impact and severity of lower GI events have actually been greater than those in the upper GI tract [ 41 ].…”

Section: Introductionmentioning

confidence: 94%

Safe prescribing of non-steroidal anti-inflammatory drugs in patients with osteoarthritis – an expert consensus addressing benefits as well as gastrointestinal and cardiovascular risks

Scarpignato

Lanas

Blandizzi

et al. 2015

BMC Med

189

129

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BackgroundThere are several guidelines addressing the issues around the use of NSAIDs. However, none has specifically addressed the upper versus lower gastrointestinal (GI) risk of COX-2 selective and non-selective compounds nor the interaction at both the GI and cardiovascular (CV) level of either class of drugs with low-dose aspirin. This Consensus paper aims to develop statements and guidance devoted to these specific issues through a review of current evidence by a multidisciplinary group of experts.MethodsA modified Delphi consensus process was adopted to determine the level of agreement with each statement and to determine the level of agreement with the strength of evidence to be assigned to the statement.ResultsFor patients with both low GI and CV risks, any non-selective NSAID (ns-NSAID) alone may be acceptable. For those with low GI and high CV risk, naproxen may be preferred because of its potential lower CV risk compared with other ns-NSAIDs or COX-2 selective inhibitors, but celecoxib at the lowest approved dose (200 mg once daily) may be acceptable. In patients with high GI risk, if CV risk is low, a COX-2 selective inhibitor alone or ns-NSAID with a proton pump inhibitor appears to offer similar protection from upper GI events. However, only celecoxib will reduce mucosal harm throughout the entire GI tract. When both GI and CV risks are high, the optimal strategy is to avoid NSAID therapy, if at all possible.ConclusionsTime is now ripe for offering patients with osteoarthritis the safest and most cost-effective therapeutic option, thus preventing serious adverse events which could have important quality of life and resource use implications.Please see related article: http://dx.doi.org/10.1186/s12916-015-0291-x.Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-015-0285-8) contains supplementary material, which is available to authorized users.

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“…Lower GIB is common, but data on lower GIB are sparse. Few studies have examined the temporal trends of GIB in the general population, and most of the available data are limited to North America 1,2,10 and Southern Europe. [11][12][13] Data from the general population in the Nordic region are lacking.…”

Section: Introductionmentioning

confidence: 99%

Thirty-Year Incidence and Mortality Trends in Upper and Lower Gastrointestinal Bleeding in Finland

et al. 2020

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IMPORTANCE Epidemiological data on lower gastrointestinal bleeding (GIB) in the general population are sparse. OBJECTIVE To describe the incidence, recurrence, mortality, and case fatality rates of major upper GIB and lower GIB in the general population of Finland between 1987 and 2016. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study used data from the 1987 to the 2012 cycles of the National FINRISK Study, a health examination survey that was conducted every 5 years in Finland. Survey participants were adults aged 25 to 74 years who were recruited from a population register by random sampling; those with a history of hospitalization for GIB were excluded. Participants were followed up from survey enrollment to onset of GIB that led to hospitalization, death from any cause, or study end (December 31, 2016). Follow-up was performed through linkage with national electronic health registers. Data were analyzed from February 1, 2019, to January 31, 2020. MAIN OUTCOMES AND MEASURES Incidence, recurrence, mortality, and case fatality rates for all, upper, lower, and unspecified GIB. Outcome measures were stratified by sex and age group. RESULTS Among the 39 054 participants included in the study, 494 (1.3%) experienced upper GIB (321 men [65.0%]; mean [SD] age, 52.8 [12.1] years) and 645 (1.7%) had lower GIB (371 men [57.5%]; mean [SD] age, 54.0 [11.7] years). The age-standardized incidence rate was 0.94 per 1000 personyears (95% CI, 0.85-1.04) for upper GIB and 1.26 per 1000 person-years (95% CI, 1.15-1.38) for lower GIB; the incidence was higher in men than in women. Between 1987 and 2016 the incidence rate of upper GIB remained mostly stable, ranging from 0.40 to 0.66 per 1000 person-years, whereas constant increases occurred in the incidence of lower GIB until the rate stabilized. The proportion of recurrent GIB events showed an increasing trend from 1987 to 2016. The upper GIB-specific mortality was higher (0.07 per 1000 person-years; 95% CI, 0.04-0.09) than the lower GIB-specific mortality (0.01 per 1000 person-years; 95% CI, 0.001-0.03). Case fatality was high for those with upper GIB (7.0%; 95% CI, 4.7-10.1) compared with those with lower GIB (0.4%; 95% CI, 0.1-1.3). Case fatality remained stable over the years but was higher in men (between 5% and 10%) than women (<2%) with GIB. CONCLUSIONS AND RELEVANCE This study found that the overall incidence rate of upper GIB was lower than the incidence of lower GIB, but the recurrence, mortality, and 28-day case fatality were higher in participants with upper GIB. These data can serve as a reference when putting into context the rates of drug-associated GIB and can inform efforts to improve GIB care and outcome and to prevent rebleeding or death for patients with major GIB.

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Time trends and outcome of gastrointestinal bleeding in the Veneto Region: A retrospective population based study from 2001 to 2010

Cited by 29 publications

References 21 publications

Epidemiology and Risk Factors for Upper Gastrointestinal Bleeding

Epidemiology and Risk Factors for Upper Gastrointestinal Bleeding

Safe prescribing of non-steroidal anti-inflammatory drugs in patients with osteoarthritis – an expert consensus addressing benefits as well as gastrointestinal and cardiovascular risks

Thirty-Year Incidence and Mortality Trends in Upper and Lower Gastrointestinal Bleeding in Finland

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