PROPHYLACTIC ASPIRIN AND RISK OF PEPTIC-ULCER BLEEDING

Objective-To determine the risks of hospitalisation for bleeding pepti c ulcer with the current prophylactic aspirin regimens of 300 mg daily or less. Design-A case-control study with hospital and community cont rols. Setting-Hospitals in Glasgow, Newcastle, Nottingham, Oxford, and Portsmouth. Subjects-1121 patients with gastric or duodenal ulcer ble eding matched with hospital and community controls. Results-144 (12.8% ) cases had been regular users of aspirin (taken at least five days a week for at least the previous month) compared with 101 (9.0%) hospita l and 77 (7.8%) community controls. Odds ratios were raised for all do ses of aspirin taken, whether compared with hospital or community cont rols (compared with combined controls: 75 mg, 2.3 (95% confidence inte rval 1.2 to 4.3); 150 mg, 3.2 (1.7 to 6.5); 300 mg, 3.9 (2.5 to 6.3)). Results were not explained by confounding influences of age, sex, pri or ulcer history or dyspepsia, or concurrent nonaspirin non-steroidal anti-inflammatory drug use. Risks seemed particularly high in patients who took non-aspirin non-steroidal anti-inflammatory drugs concurrent ly. Conclusion-No conventionally used prophylactic aspirin regimen see ms free of the risk of peptic ulcer complications.