RESEARCH - Minidose aspirin and GI bleeding - a retrospective, case-control study

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Dig Dis Sci. 2005 Sep;50(9):1621-4.

Minidose aspirin and gastrointestinal bleeding--a retrospective,

case-control study in hospitalized patients.

Sapoznikov B, Vilkin A, Hershkovici M, Fishman M, Eliakim R, Niv Y.

Department of Gastroenterology, Rabin Medical Center, Beilinson Campus, Tel

Aviv University, Israel.

Low or minimal doses of aspirin are widely used for prevention of

cardiovascular diseases. Aspirin is known to produce severe adverse

gastrointestinal effects, such as bleeding and perforation. Less is known

about the risk associated with minidose aspirin. Our aim was to assess the

possible association of upper gastrointestinal tract bleeding with minidose

aspirin therapy. A retrospective controlled design was used. Patients

hospitalized for melena or hematemesis between January 1, 2000, and December

31, 2001, were identified by ICD-9 codes, and their clinical findings were

compared to these of patients without upper gastrointestinal bleeding

hospitalized during the same period and matched for age and sex. Bleeding

was attributed to therapy if patients used a nonsteroidal anti-inflammatory

drug or aspirin therapy within 30 days before hospitalization. The study

group included 318 patients (59% male), and the control group 141 (65%

male). Mean ages were 67 +/- 19 and 64 +/- 19 years, respectively. Study

patients had more accompanying diseases, used more medications, and required

more blood transfusions than controls (37%, vs. 2% of controls; P < 0.001).

Minidose aspirin was used by 28% of the study group and 18% of the controls

(P = 0.03). The average dose was 40 +/- 86 and 21 +/- 55 mg/day,

respectively (P = 0.012). Only 26% of the study patients received a gastric

protective agent. On multivariate analysis, aspirin consumption was the only

independent risk factor for upper gastrointestinal tract bleeding. There

appears to be an association between minidose aspirin treatment and

hospitalization for upper gastrointestinal tract bleeding. Despite the

advanced age of the patients, only one-quarter were treated with gastric

protective agent.

PMID: 16133960

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstra\

ct & list_uids=16133960 & itool=iconabstr & query_hl=74 & itool=pubmed_DocSum

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