Gut Liver.  2012 Oct;6(4):423-426.

Characteristics of Hemorrhagic Peptic Ulcers in Patients Receiving Antithrombotic/Nonsteroidal Antiinflammatory Drug Therapy

Affiliations
  • 1Department of Medicine and Bioregulatory Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan. knakamur@intmed3.med.kyushu-u.ac.jp
  • 2Department of Gastroenterology, Aso Iizuka Hospital, Fukuoka, Japan.
  • 3Department of Internal Medicine, Saiseikai Fukuoka General Hospital, Fukuoka, Japan.
  • 4Center for Gastroenterology, Kyushu Medical Center, Fukuoka, Japan.
  • 5Department of Gastroenterology and Hepatology, Fukuoka-Higashi Medical Center, Fukuoka, Japan.
  • 6Department of Gastroenterology, Hara Sanshin Hospital, Fukuoka, Japan.

Abstract

BACKGROUND/AIMS
Antithrombotic/nonsteroidal antiinflammatory drug (NSAID) therapies increase the incidence of upper gastrointestinal bleeding. The features of hemorrhagic peptic ulcer disease in patients receiving antithrombotic/NSAID therapies were investigated.
METHODS
We investigated the medical records of 485 consecutive patients who underwent esophagogastroduodenoscopy and were diagnosed with hemorrhagic gastroduodenal ulcers. The patients treated with antithrombotic agents/NSAIDs were categorized as the antithrombotic therapy (AT) group (n=213). The patients who were not treated with antithrombotics/NSAIDs were categorized as the control (C) group (n=263). The clinical characteristics were compared between the groups.
RESULTS
The patients in the AT group were significantly older than those in the C group (p<0.0001). The hemoglobin levels before/without transfusion were significantly lower in the AT group (8.24+/-2.41 g/dL) than in the C group (9.44+/-2.95 g/dL) (p<0.0001). After adjusting for age, the difference in the hemoglobin levels between the two groups remained significant (p=0.0334). The transfusion rates were significantly higher in the AT group than in the C group (p=0.0002). However, the outcome of endoscopic hemostasis was similar in the AT and C groups.
CONCLUSIONS
Patients with hemorrhagic peptic ulcers receiving antithrombotic/NSAID therapies were exposed to a greater risk of severe bleeding that required transfusion but were still treatable by endoscopy.

Keyword

Peptic ulcer; Hemorrhagic ulcer; Antithrombotic therapy; Anti-inflammatory agents, non-steroidal; Endoscopic hemostasis

MeSH Terms

Anti-Inflammatory Agents, Non-Steroidal
Endoscopy
Endoscopy, Digestive System
Hemoglobins
Hemorrhage
Hemostasis, Endoscopic
Humans
Incidence
Medical Records
Peptic Ulcer
Anti-Inflammatory Agents, Non-Steroidal
Hemoglobins
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