The low risk of upper gastrointestinal bleeding in patients dispensed corticosteroids.
OBJECTIVE
To determine the incidence of upper gastrointestinal bleeding in patients treated with corticosteroids.


METHODS
The incidence of upper gastrointestinal tract bleeding was assessed in a cohort of 19,880 patients from the Michigan Medicaid billing database with dermatitis and/or asthma treated with corticosteroids during 1980 to 1984. The frequency of upper gastrointestinal bleeding was assessed within 60 days after each corticosteroid prescription.


RESULTS
The incidence of upper gastrointestinal bleeding in patients without a past history of upper gastrointestinal bleeding who were exposed to corticosteroids was only 2.8 cases per 10,000 person-months. The rate of upper gastrointestinal bleeding was notably higher in patients receiving anticoagulants and those with a prior history of upper gastrointestinal bleeding (23.0 and 15.9 cases per 10,000 person-months, respectively).


CONCLUSIONS
Because the incidence of upper gastrointestinal bleeding in ambulatory patients treated with corticosteroids is so low, prophylactic therapy should be restricted to high-risk patients, if it is to be used at all.
Carson
J L
JL
Department of Medicine, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick.
Strom
B L
BL
Schinnar
R
R
Duff
A
A
Sim
E
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000188:drug therapy; D015331:Cohort Studies; D003625:Data Collection / Q000379:methods; D003872:Dermatitis / Q000188:drug therapy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced*; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016012:Poisson Distribution; D012189:Retrospective Studies; D012306:Risk
D005938:Glucocorticoids