A PROFILE OF PATIENTS ON ASA OR NSAIDS HOSPITALIZED WITH GASTROINTESTINAL PERFORATIONS

Background: In a recent clinical trial gastrointestinal tract perforat ions in patients on nonsteroidal anti-inflammatory drugs (NSAIDs) were found to occur with a frequency of 0.15%, and possibly to be reduced in patients concomitantly using the cytoprotective agent misoprostol. Objective: To characterize patients with gastrointestinal perforations admitted to the two major referral teaching hospitals in Edmonton, Al berta between January 1, 1989 and December 31, 1993. Methods: A comput erized search program was used to select patient charts containing pre selected International Classification of Diseases (ICD) 9-CM codes, an d patients were organized into four study groups based upon drug use; those taking NSAIDs, those taking acetylsalicylic acid (ASA), those ta king both NSAIDs and ASA, and those taking neither NSAIDs nor ASA. Res ults: The following significant characteristics were identified in the 428 patients admitted with perforations: only a minority (29%) were t aking either NSAIDs or ASA; NSAID users were likely to be female, whil e those using either NSAIDs or ASA; NSAID users were likely to be male ; females were older than males; patients taking NSAIDs, ASA or both w ere more often asymptomatic at presentation compared with those not us ing these drugs; and upper gastrointestinal tract perforations were mo re likely to occur in the duodenum than in the stomach, while lower ga strointestinal tract perforations were more likely to occur in the col on than in the small intestine. Conclusion: This retrospective descrip tive study outlines the profile of a patient presenting to a referral hospital with a gastrointestinal perforation. Furthermore, it suggests that NSAID and/or ASA use significantly alters this profile compared with that in patients using neither NSAIDs nor ASA.