NSAIDs increase risk of gastrointestinal bleeding in primary care patients with dyspepsia.
BACKGROUND
A 1-year prospective study of 545 patients with dyspepsia examined the natural history of dyspepsia in a primary care population. Predictors of gastrointestinal bleeding and other related utilization-of-service indicators were identified.


METHODS
Subjects were adult primary care patients seen at a southern California county medical center. Data were collected by means of a patient questionnaire as well as from medical charts and a computerized hospital billing system. Chi-square, t test, and stepwise multiple logistic regression analyses were used to analyze the data. Outcome events were follow-up visits for any gastrointestinal event and follow-up visits for gastrointestinal bleeding specifically.


RESULTS
Prior exposure to nonsteroidal anti-inflammatory drugs doubled the odds for any follow-up gastrointestinal event (odds ratio = 1.9; 95% CI = 1.4 to 2.8). Nonsteroidal anti-inflammatory drugs increased the risk for gastrointestinal bleeding by a factor of 7 (odds ratio = 7.1; 95% CI = 1.3 to 50.0).


CONCLUSIONS
In a cohort of primary care patients with dyspepsia, use of nonsteroidal anti-inflammatory drugs was the most important predictor of a follow-up gastrointestinal event, both for any gastrointestinal event and gastrointestinal bleeding specifically.
Kurata
J H
JH
San Bernardino County Medical Center, CA 92404, USA.
Nogawa
A N
AN
Noritake
D
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001168:Arthritis / Q000188:drug therapy; D004415:Dyspepsia / Q000150:complications*; D005194:Family Practice; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology / Q000517:prevention & control; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal