title: [Accumulation of risk factors before acute gastroduodenal hemorrhage: analgesic/antirheumatic drugs, alcohol and ulcer anamnesis].
abstract: 72 patients with acute hemorrhage from gastroduodenal peptic lesions were asked about their drug and alcohol consumption as well as about their smoking habits, 43 of them (60%) had used analgetic or antiinflammatory drugs on at least 3 days during the week preceding the gastrointestinal (g. i.) hemorrhage, 20 patients had used more than on drug, 4 patients an overdose of one drug. During a therapy with corticosteroids alone only one thrombopenic patient bled. 21 patients (29%) had an abnormal high alcohol consumption. In the control group significantly fewer patients had such a drug and alcohol history (p less than 0.01 and p less than 0.05, respectively). The relative risk of a g. i. hemorrhage following an exposition with analgetic/antiinflammatory drugs was RR = +7.41 +/- 5.8. Strikingly, 43 patients (60%) had an ulcer history or a g.i. hemorrhage in the past. In 46 per cent of all patients the risk factors analgesic/antiinflammatory drug, alcohol and ulcer history accumulated before the acute hemorrhage. A more careful indication and dosage of analgesic and antiinflammatory drug therapy might reduce the frequency of g.i. hemorrhage. Most of the patients were male (76%). 39 patients (54%) were older than 60 years. The average age of the 6 patients who died was 73 +/- 6.3 years. After analgesic/antiinflammatory treatment the clinical course was by no means better than in the case of spontaneously occurring lesions. Endoscopically, following exposition with analgesic/antiinflammatory drugs more frequently erosions (p less than 0.05), multiple ulcers and gastric ulcers (no statistical significance) were observed.
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking; D000700:Analgesics / Q000009:adverse effects*; D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D004381:Duodenal Ulcer / Q000139:chemically induced / Q000150:complications*; D006801:Humans; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000139:chemically induced*; D012306:Risk; D013276:Stomach Ulcer / Q000139:chemically induced / Q000150:complications*
chemical_list: D000700:Analgesics; D000893:Anti-Inflammatory Agents
vernacular_title: Kumulation von Risikofaktoren vor der akuten gastroduodenalen Blutung: Schmerz-/Rheumamittel, Alkohol und Ulkusanamnese.