title: Exposure to nonsteroidal anti-inflammatory drugs among older adult patients hospitalized for peptic ulcer disease in Argentina: A case-control study.
abstract: OBJECTIVE
  This study examined the association between exposure to nonselective NSAIDs and hospitalization for peptic ulcer disease (PUD) among older adults in Argentina.
  
  
  METHODS
  This was a case-control study based on the medical records of 5 hospitals in Buenos Aires. Cases were patients aged > or =50 years and hospitalized with PUD between 1997 and 2002 who were identified by mode of presentation (acute abdominal pain, vomiting, hematemesis, melena, shock, and asymptomatic anemia, or admission for an unknown reason and a discharge diagnosis related to upper gastrointestinal complications). Controls were hospitalized patients without PUD and were matched to cases (1:1) by age, sex, and admission date. NSAID exposure was defined as the use of NSAIDs during the year before admission. Conditional logistic regression analysis was used to examine the association between exposure to nonselective NSAIDs and hospitalizations for PUD, after adjusting for predictors. Subgroup analyses were conducted on patients with severe PUD, moderate PUD, and those whose PUD was confirmed by endoscopy.
  
  
  RESULTS
  The study included 324 cases and 324 matched controls. The mean patient age was 74 years. The discharge diagnoses indicated severe PUD in 46.3% (150/324), moderate PUD in 49.4% (160/324), and mild PUD in 4.3% (14/324) of cases. NSAID exposure was associated with an increased risk of hospitalization for PUD (odds ratio [OR], 5.20; 95% CI, 3.31-8.15). Risk was also increased for severe PUD (OR, 4.24; 95% CI, 2.29-7.87) and moderate PUD (OR, 6.08; 95% CI, 3.09-11.96). A history of upper gastrointestinal complications was independently associated with hospitalization for PUD (OR, 14.62; 95% CI, 6.70-31.91).
  
  
  CONCLUSIONS
  Use of nonselective NSAIDs is a significant risk factor for PUD-related hospitalizations among older adults in Argentina. The magnitude of the risk ratio resembles that reported for developed countries.
authors.affiliation: Clinical Effectiveness Program, University of Buenos Aires School of Public Health/Hospital Italiano de Buenos Aires, Health Care Administration Program, Hospital Universitario Austral, Universidad Austral, Buenos Aires, Argentina.
authors.forename: Jorge
authors.initials: J
authors.lastname: Insúa
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Mavros
authors.forename: Elke
authors.initials: E
authors.lastname: Hunsche
authors.forename: Sheldon
authors.initials: S
authors.lastname: Kong
authors.forename: Osvaldo
authors.initials: O
authors.lastname: Tibaudin-Agver
mesh_terms: D000367:Age Factors; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D001118:Argentina / Q000453:epidemiology; D016022:Case-Control Studies; D002908:Chronic Disease; D015897:Comorbidity; D004363:Drug Utilization; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000139:chemically induced*; D012306:Risk
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal