THE RELATIONSHIP BETWEEN UPPER GASTROINTESTINAL HEMORRHAGE AND DRUG-USE - A CASE-CONTROL STUDY

?The relationship between upper gastrointestinal hemorrhage and drug u se was studied in 251 Chinese patients (179 men, 72 women) admitted to the Prince of Wales Hospital, Hong Kong, and control subjects matched for age and sex. There was a highly significant difference between th e cases and control subjects in the use of NSAIDs (odds ratio 14.0, p < 0.00001), ulcer healing drugs (odds ratio 12.5, p < 0.00001), and Ch inese proprietary medicines (odds ratio 16.0, p < 0.00001). There was also a significant difference in the use of analgesics (odds ratio 14. 0, p = 0.001), paracetamol (odds ratio 2.5, p = 0.01), antacids (odds ratio 2.7, p < 0.001) and unknown drugs (odds ratio 4.7, p < 0.001). C ases also differed from control subjects regarding the use of tobacco (odds ratio 2.3, p < 0.001) and alcohol (odds ratio 1.7, p = 0.02), an d the presence of peptic ulcer symptoms (odds ratio 29.8, p < 0.00001) . Significantly more control subjects than cases were receiving aspiri n, cardiovascular drugs, bronchodilators, oral hypoglycemic drugs/lipi d-lowering drugs, and anticonvulsants/hypnotics, due to the inevitable differences in disease pattern between the 2 groups. NSAID use was a major factor associated with upper gastrointestinal hemorrhage from pr imarily peptic ulcers. Differences in the use of other drugs may refle ct variations in disease patterns between cases and controls, the comm on practice of self-medication in Hong Kong, and the concomitant use o f NSAIDs and ulcer healing drugs/antacids.