Abstract

COUTO, Gilberto; MACEDO, Guilherme  and  RIBEIRO, Filipe. Upper gastrointestinal bleeding associated with acetylsalicylic acid and non-steroidal antiinflammatory drugs in Portugal Results from PARAINES study. J Port Gastrenterol. [online]. 2010, vol.17, n.5, pp.200-206. ISSN 0872-8178.

INTRODUCTION: Acetylsalicylic acid (ASA) and non-steroidal anti-inflammatory drugs (NSAIDs) are amongst the most prescribed drugs in the world and may lead to peptic ulcer related bleeding and death. PATIENTS AND METHODS: PARAINES study was a multicentre and retrospective study whose objective was to characterize the magnitude and management of ASA/NSAIDs related upper gastrointestinal bleeding in Portugal (9 centres; referral population 2.5 million) in 2006. RESULTS: We report 291 hospitalizations for 280 patients (estimated incidence 145.5/100000 ASA/NSAIDs consumers/year). Two thirds were male; 68.7% were older than 65 years and 24.1% had a previous history of peptic ulcer. Low-dose ASA was the most prescribed drug. Fifteen per cent of the patients with gastrointestinal risk were taking a proton pump inhibitor for gastric protection. 237 peptic ulcers were diagnosed, 51% with endoscopic high-risk stigmata, usually treated with dual injection therapy (77.2%) and IV proton pump inhibitors (33% high dose continuous infusion). Ten patients died during hospitalization (3.6%; estimated incidence 5/100000 ASA/NSAIDs consumers/year). CONCLUSIONS: Hospitalization and in-hospital mortality incidence of ASA/NSAIDs related upper gastrointestinal bleeding in Portugal were lower than expected; only a few patients with associated risk factors are actually on proton pump inhibitors prophylaxis; peptic ulcer bleeding treatment may be further optimized.

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