title: [Nonvariceal upper gastrointestinal hemorrhage associated with nonsteroidal anti-inflammatory drugs in Metropolitan Lima].
abstract: OBJECTIVE
  The purpose of this study was to evaluate the frequency of upper gastrointestinal hemorrhage associated with nonsteroidal anti-inflammatory drugs (NSAIDs).
  
  
  METHODS
  This investigation was prospective, descriptive and analytical. We evaluated patients with nonvariceal upper gastrointestinal hemorrhage in the gastroenterological services of the Edgardo Rebagliati, Hipólito Unanue, Dos de Mayo and Cayetano Heredia Hospitals, in Lima-Peru. Patients with chronic liver diseases or variceal hemorrhage were excluded. The statistics tests were calculated using Microsoft Excel and Epiinfo Program.
  
  
  RESULTS
  Over the 13-month period a total of 117 patients were enrolled (77 men and 40 women); the average age was of 57.86 years (range: 14-85 years) 63 (54%) were taking NSAIDs; 60% were given aspirin, 28.5% ibuprofen 15.8% diclofenac (and 15.8% naproxen; 31% were taking simultaneously various NSAIDs; 65% was over 60 years old. More prescriptions of NSAIDs came from cardiology, internal medicine and rheumatology. However, 55.4% took them without having medical prescription. The most important risk factor was the age over 65 years (p<0.001). In our study the presence of cardiovascular and rheumatic diseases were significant risk factors (p<0.001). Gastric ulcer was more frequent in the group NSAIDs 31 (49%), vs 14 (26%) in the p<0.001, and the duodenal ulcer in the non-NSAIDs group 32 (59%) vs 19 (30%) in p<0.01; the erosive gastritis were 13 (20.6%) in the NSAIDs group vs 18 (33%) p<0.01. There were significant clinical findings in the NSAIDs group with presence of ulcer syndrome and hematemesis (p<0.001). The level of hemoglobin and the number of transfusions was not significantly different in the groups. In the NSAIDs group, 35 (55 %) p<0.001. presented digestive injuries with no evidence of symptoms before the bleeding started.
  
  
  CONCLUSIONS
  In this study, the association between nonvariceal upper gastrointestinal hemorrhage and the use of NSAIDs was significantly high in Lima, specially in elderly population, and the peptic ulcer was the most common, particularly the gastric type.
authors.affiliation: Facultad de Medicina, Universidad Ricardo Palma, Lima, Peru.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Salvatierra Laytén
authors.forename: Liz
authors.initials: L
authors.lastname: de la Cruz Romero
authors.forename: Marja
authors.initials: M
authors.lastname: Paulino Merino
authors.forename: Vanesa
authors.initials: V
authors.lastname: Vidal Vidal
authors.forename: Cielo
authors.initials: C
authors.lastname: Rivera Dávila
authors.forename: Alicia
authors.initials: A
authors.lastname: Cano Chuquilin
authors.forename: Oscar
authors.initials: O
authors.lastname: Frisancho Velarde
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010568:Peru; D011446:Prospective Studies; D014505:Urban Population
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal