NSAIDS INCREASE RISK OF GASTROINTESTINAL-BLEEDING IN PRIMARY-CARE PATIENTS WITH DYSPEPSIA

BACKGROUND. A 1-year prospective study of 545 patients with dyspepsia examined the natural history of dyspepsia in a primary care population . Predictors of gastrointestinal bleeding and other related utilizatio n-of-service indicators were identified. METHODS. Subjects were adult primary care patients seen at a southern California county medical cen ter, Data were collected by means of a patient questionnaire as well a s from medical charts and a computerized hospital billing system. Chi- square, t test, and stepwise multiple logistic regression analyses wer e used to analyze the data, Outcome events were follow-up visits for a ny gastrointestinal event and follow-up visits for gastrointestinal bl eeding specifically. RESULTS. Prior exposure to nonsteroidal anti-infl ammatory drugs doubled the odds for any follow-up gastrointestinal eve nt (odds ratio = 1.9; 95% Cl = 1.4 to 2.8). Nonsteroidal anti-inflamma tory drugs increased the risk for gastrointestinal bleeding by a facto r of 7 (odds ratio = 7.1; 95% Cl = 1.3 to 50.0). CONCLUSIONS. In a coh ort of primary care patients with dyspepsia, use of nonsteroidal anti- inflammatory drugs was the most important predictor of a follow-up gas trointestinal event, both for any gastrointestinal event and gastroint estinal bleeding specifically.