title: Upper Gastrointestinal Bleeding in Japanese Patients Prescribed Antithrombotic Drugs: Differences in Trends over Time.
abstract: OBJECTIVE
  We studied the features of upper gastrointestinal bleeding (UGIB) in patients taking antithrombotic drugs.
  
  
  METHODS
  The records of 430 patients taking antithrombotic drugs who underwent emergency endoscopy for UGIB in Saga Medical School Hospital between 2002 and 2011 were studied. We also compared the characteristics of our cohort of 11,919 patients prescribed antithrombotic drugs in our hospital between 2002 and 2011. UBGI patients of variceal bleeding were not included in this study.
  
  
  RESULTS
  186 patients presented with UGIB in the first period (2002-2006) and 244 in the second period (2007-2011). The proportion of patients infected with Helicobacter pylori was lower in the second period, while the proportion taking antithrombotic drugs rose significantly. Peptic ulcer disease was responsible for the majority of bleeding episodes; however, bleeding from other sources is increasing. In the whole cohort, the risk of UGIB was 1.08%; however, of the 31.8% who also took an acid-secretion inhibitor only 18 (0.28%) developed bleeding. In contrast, 102 (1.87%) of those not taking an acid-secretion inhibitor developed UGIB, a statistically significant difference.
  
  
  CONCLUSIONS
  Risk of UGIB in Japanese patients taking antithrombotics was 1.01% and the incidence is increasing. Acid-secretion inhibitors reduced the risk of antithrombotic drug-related UGIB.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Yamaguchi
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Sakata
authors.forename: Nanae
authors.initials: N
authors.lastname: Tsuruoka
authors.forename: Ryo
authors.initials: R
authors.lastname: Shimoda
authors.forename: Toru
authors.initials: T
authors.lastname: Higuchi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sakata
authors.forename: Kazuma
authors.initials: K
authors.lastname: Fujimoto
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Iwakiri
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D044466:Asian People; D015897:Comorbidity; D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000208:ethnology; D011307:Drug Prescriptions; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects*; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced* / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control; D006801:Humans; D006973:Hypertension / Q000208:ethnology; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000139:chemically induced / Q000175:diagnosis / Q000208:ethnology; D010818:Practice Patterns, Physicians' / Q000639:trends*; D065840:Protective Factors; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
chemical_list: D000897:Anti-Ulcer Agents; D005343:Fibrinolytic Agents