title: A nationwide study of mortality associated with hospital admission due to severe gastrointestinal events and those associated with nonsteroidal antiinflammatory drug use.
abstract: BACKGROUND
  The worst outcome of gastrointestinal complications is death. Data regarding those associated with nonsteroidal antiinflammatory drug (NSAID) or aspirin use are scarce.
  
  
  OBJECTIVE
  To determine mortality associated with hospital admission due to major gastrointestinal (GI) events and NSAID/aspirin use.
  
  
  METHODS
  The study was based on actual count of deaths from two different data sets from 2001. Study 1 was carried out in 26 general hospitals serving 7,901,198 people. Study 2 used a database from 197 general hospitals, representative of the 269 hospitals in the Spanish National Health System. Information regarding gastrointestinal complications and deaths was obtained throughout the Minimum Basic Data Set (CIE-9-MC) provided by participating hospitals. Deaths attributed to NSAID/aspirin use were estimated on the basis of prospectively collected data from hospitals of study 1.
  
  
  RESULTS
  The incidence of hospital admission due to major GI events of the entire (upper and lower) gastrointestinal tract was 121.9 events/100,000 persons/year, but those related to the upper GI tract were six times more frequent. Mortality rate was 5.57% (95% CI = 4.9-6.7), and 5.62% (95% CI = 4.8-6.8) in study 1 and study 2, respectively. Death rate attributed to NSAID/aspirin use was between 21.0 and 24.8 cases/million people, respectively, or 15.3 deaths/100,000 NSAID/aspirin users. Up to one-third of all NSAID/aspirin deaths can be attributed to low-dose aspirin use.
  
  
  CONCLUSIONS
  Mortality rates associated with either major upper or lower GI events are similar but upper GI events were more frequent. Deaths attributed to NSAID/ASA use were high but previous reports may have provided an overestimate and one-third of them can be due to low-dose aspirin use.
authors.affiliation: Servicio de Aparato Digestivo, Hospital Clínico Zaragoza, Zaragoza, Spain.
authors.forename: Angel
authors.initials: A
authors.lastname: Lanas
authors.forename: Maria Angeles
authors.initials: MA
authors.lastname: Perez-Aisa
authors.forename: Faust
authors.initials: F
authors.lastname: Feu
authors.forename: Julio
authors.initials: J
authors.lastname: Ponce
authors.forename: Esteban
authors.initials: E
authors.lastname: Saperas
authors.forename: Santos
authors.initials: S
authors.lastname: Santolaria
authors.forename: Luis
authors.initials: L
authors.lastname: Rodrigo
authors.forename: Joaquim
authors.initials: J
authors.lastname: Balanzo
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bajador
authors.forename: Pedro
authors.initials: P
authors.lastname: Almela
authors.forename: Jose M
authors.initials: JM
authors.lastname: Navarro
authors.forename: Fernando
authors.initials: F
authors.lastname: Carballo
authors.forename: Manuel
authors.initials: M
authors.lastname: Castro
authors.forename: Enrique
authors.initials: E
authors.lastname: Quintero
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001241:Aspirin / Q000009:adverse effects; D005260:Female; D005767:Gastrointestinal Diseases / Q000139:chemically induced* / Q000453:epidemiology / Q000401:mortality*; D006471:Gastrointestinal Hemorrhage / Q000401:mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D013030:Spain / Q000453:epidemiology
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin