scholarly journals Do NSAIDs and ASA Cause More Upper Gastrointestinal Bleeding in Elderly than Adults?

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Hakan Kocoglu ◽  
Basak Oguz ◽  
Hakan Dogan ◽  
Yildiz Okuturlar ◽  
Mehmet Hursitoglu ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Bleeding Risk ◽  
Adult Patients ◽  
Elderly Subjects ◽  
Group 2 ◽  
Upper Gastrointestinal ◽  
Gastroprotective Drugs ◽  
Group 1

Purpose. NSAIDs and ASA may cause upper gastrointestinal bleeding (UGIB) both in adults and in elderly. There is no study that compares this increased bleeding risk between adult and elderly subjects.Methods. A total of 524 patients with UGIB were included in this study. The data of patients were, respectively, analyzed.Results. NSAIDs and ASA-associated UGIB rates were similar between <65 years (345 patients) (group 1) and ≥65 years (179 patients) (group 2) (28.4% versus 23.5%,p=0.225and 13% versus 19%,p=0.071, resp.). Warfarin-associated UGIB was found significantly higher in group 2 than group 1. Elderly patients with NSAID-associated UGIB had significantly higher length of stay (LoS) and CoH than adult patients with NSAID-associated UGIB (p=0.002and 0.001, resp.). Elderly patients with ASA-associated UGIB had significantly higher CoH than adult patients with NSAID-associated UGIB.Conclusions. Using NSAIDs without gastroprotective drugs or using ASA with gastroprotective drugs in elderly patients is as safe as in adult patients. Not only should adding gastroprotective drugs to ASA or NSAID be based on their risk of UGIB, but the cost of hospitalization of ASA or NSAID-associated UGIB should be considered.

scholarly journals Risk of Lower and Upper Gastrointestinal Bleeding, Transfusions, and Hospitalizations With Complex Antithrombotic Therapy in Elderly Patients

Circulation ◽  
2013 ◽  
Vol 128 (17) ◽  
pp. 1869-1877 ◽  
Author(s):  
Neena S. Abraham ◽  
Christine Hartman ◽  
Peter Richardson ◽  
Diana Castillo ◽  
Richard L. Street ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Gastrointestinal Bleeding ◽  
Antithrombotic Therapy ◽  
Upper Gastrointestinal Bleeding ◽  
Upper Gastrointestinal

scholarly journals Upper Gastrointestinal Bleeding in Adults Under Veno-Arterial Extracorporeal Membrane Oxygenation: A Single-Center Retrospective Study

2021 ◽  
Author(s):  
jules stern ◽  
Claire Dupuis ◽  
Jean Reuter ◽  
Camille Vinclair ◽  
Marylou Para ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Extracorporeal Membrane Oxygenation ◽  
Upper Gastrointestinal Bleeding ◽  
Univariate Analysis ◽  
Adult Patients ◽  
Membrane Oxygenation ◽  
Claude Bernard ◽  
Increased Risk ◽  
Va Ecmo ◽  
Upper Gastrointestinal

Abstract Objective. Upper gastrointestinal bleeding is a common complication in adults treated with veno-arterial Extracorporeal Membrane Oxygenation (VA-ECMO) for refractory cardiogenic shock or cardiac arrest. We aimed to determine risk factors, prevalence and outcomes associated with upper gastrointestinal bleeding (UGIB) in adult patients under VA-ECMO.Design. We conducted a retrospective cohort study (2014-2017) on consecutive VA-ECMO patients.Setting. Medical and Infectious Disease intensive care unit of university hospital Bichat-Claude Bernard in Paris, France.Patients. UGIB was defined as 1) an overt bleeding (hematemesis, melena, hematochezia), or 2) acute anemia associated with a lesion diagnosed on upper gastrointestinal endoscopy. Cause-specific models were used to identify factors associated with UGIB and death, respectively.Measurements and Main Results. 257 patients were included, of whom 48 (19%) were diagnosed with UGIB after a median of 18 [7; 43] days following cannulation; median SAPS II was 59 [43; 76]. 100 (39%) patients were implanted after cardiac surgery. Mortality occurred in 31 (65%) patients with UGIB and 121 (58%) patients without. UGIB patients had longer ICU stays (41 [19; 82] vs. 15 [6; 26]; p<.01), longer ECMO (10.5 [7; 15] vs 6 [3; 10]; p <.01) and mechanical ventilation durations (31 [18; 45] vs. 9 [5; 18]; p <.01) in days, as compared to non-UGIB patients. Ninety-nine upper gastrointestinal endoscopies (UGE) were performed and the most frequent lesions detected were gastro-duodenal ulcers (n=28, 28%), leading to 12/99 therapeutic procedures. Neither antiplatelet therapy prior to ICU admission nor a history of peptic ulcer were associated with UGIB in univariate analysis. By multivariate analysis (table), a BMI (body mass index) > 30 kg/m2 (Cause-specific hazard ratio (CSHR) [95% CI]): 3.06 [1.56; 5.98]), and extracorporeal cardiopulmonary resuscitation (ECPR) (CSHR 2.34 [1.03; 5.35]) were independently associated with an increased risk of UGIB. Conclusions. In adult patients under VA-ECMO, obesity and ECPR were independently associated with UGIB. This study highlights the potential role of obesity and acute ischemia reperfusion injury in the pathophysiology of VA-ECMO-associated UGIB.

scholarly journals Upper gastrointestinal bleeding: risk factors for mortality in two urban centers in Latin America

2011 ◽  
Vol 103 (1) ◽  
Author(s):  
C. H. Morales Uribe ◽  
S. Sierra Sierra ◽  
A. M. Hernández Hernández ◽  
A. F. Arango Durango ◽  
G. A. Lopez
Keyword(s):  
Risk Factors ◽  
Latin America ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Bleeding Risk ◽  
Urban Centers ◽  
Upper Gastrointestinal
Sign in / Sign up

Export Citation Format

Share Document