Risk of hospitalization for upper gastrointestinal tract bleeding.
OBJECTIVE
This study evaluates the hospitalization risk for upper gastrointestinal bleeding (UGIB) with reference to the clinical characteristics of patients and drugs taken before admission.


METHODS
This study is based on the GIFA (Italian Group for the Pharmacosurveillance in the Elderly) database. Cases with an ICD-9 code of esophagus, stomach or duodenum bleeding, or acute esophago-gastroduodenal disease associated with anemia have been classified as UGIB. Sex, age, year of observation, drugs taken at home, comorbidity, smoking, alcohol, and use of gastroprotectants have been also taken into account. Statistical analysis has been conducted using multivariate logistic regression models.


RESULTS
32,388 patients have been enrolled, 940 of which presented UGIB. Age, comorbidity, use of smoke and alcohol, hospitalization duration, and mortality during hospitalization were significantly higher in UGIB than nonUGIB patients. Increased UGIB risk has been found in patients taking NSAIDs (both when aspirin was included or excluded), acetaminophen, constipating agents, iron, ethacrynic acid, propranolol. Reduced UGIB risk has been found in patients taking nitrates.


CONCLUSIONS
UGIB risk appears to correlate with clinical characteristics of the patient: it increases with age, comorbidity, and smoke and alcohol consumption. Among drugs, NSAIDs are associated with the highest UGIB risk, while nitrates with a reduction of risk.
Gallerani
M
M
Department of Clinical and Experimental Medicine, Section of Internal Medicine, University of Ferrara, 44100 Ferrara, Italy. galleranim@libero.it
Simonato
M
M
Manfredini
R
R
Volpato
S
S
Vigna
G B
GB
Fellin
R
R
D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D000930:Antidiarrheals / Q000009:adverse effects; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced* / Q000628:therapy*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007501:Iron / Q000009:adverse effects; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000930:Antidiarrheals; D007501:Iron