Do nonsteroidal anti-inflammatory drugs affect the outcome of patients admitted to hospital with lower gastrointestinal bleeding?
OBJECTIVE
To determine whether the outcome of patients admitted to hospital with lower gastrointestinal bleeding (LGB) is affected by their use of aspirin (ASA) or non-aspirin nonsteroidal anti-inflammatory drugs (NANSAIDs).


METHODS
A retrospective review of all patients admitted to Wellington Hospital over a four-and-a-half-year period from January 1998 with a coded discharge diagnosis that included LGB. Data were collected on requirement for blood transfusion (BT), number of units transfused, drug use, requirement for surgery, and in-hospital mortality.


RESULTS
There were 168 admissions to hospital with LGB over the study period of which, after exclusions, 146 formed the basis of this study. The mean age of patients was 69 years, with an equal gender distribution. Fifty three per cent of patients were taking medication known to interfere with platelet function (42% ASA, 18% NANSAIDs, and 7% both). Diverticular disease was the most common diagnosis. Eight patients required surgery for bleeding and there were two in-hospital deaths (1.4%). Forty three per cent of admitted patients required BT. Patients taking ASA or NANSAIDs (drug group) were more likely to receive a BT (relative risk 2.7, p <0.00001) than patients in the non-drug group. The median number of units received in transfused patients and requirement for surgery, although higher in the drug group, were not statistically different between the drug the non-drug group.


CONCLUSIONS
Patients admitted to hospital with LGB while taking ASA or NANSAIDs are significantly more likely to need BT but use of these agents does not result in a more frequent requirement for surgery.
Yong
David
D
Hutt Hospital, Lower Hutt, New Zealand.
Grieve
Philip
P
Keating
John
J
D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001241:Aspirin / Q000009:adverse effects*; D001803:Blood Transfusion; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin