Upper gastrointestinal bleeding in hospital inpatients: the role of antithrombotic drugs
Background Critically ill patients are considered to be most at risk from developing non-variceal upper gastrointestinal bleeding (NVGIB) while in hospital. The increasing prescription of low-dose aspirin and other antithrombotic drugs for protection against thromboembolism to many patients admitted...
Gespeichert in:
| Veröffentlicht in: | Postgraduate medical journal 2014-08, Vol.90 (1066), p.429-433 |
|---|---|
| Hauptverfasser: | , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 433 |
|---|---|
| container_issue | 1066 |
| container_start_page | 429 |
| container_title | Postgraduate medical journal |
| container_volume | 90 |
| creator | Taha, Ali S Kelly, Claire McCloskey, Caroline Craigen, Theresa Angerson, Wilson J |
| description | Background Critically ill patients are considered to be most at risk from developing non-variceal upper gastrointestinal bleeding (NVGIB) while in hospital. The increasing prescription of low-dose aspirin and other antithrombotic drugs for protection against thromboembolism to many patients admitted to hospital may increase the vulnerability of a wider group to NVGIB. Objective This study compares two groups of patients with NVGIB: group I, inpatients cared for outside the intensive care unit; and group II, patients admitted with this condition, while considering the use of antithrombotic drugs. Methods We identified all patients who developed NVGIB in the two calendar years between 2008 and 2009 and compared group I with group II while taking into account their clinical details including Rockall scores and drug usage. Results Compared with group II (n=274), group I (n=96) were older (median age of 77 years vs 68; p |
| doi_str_mv | 10.1136/postgradmedj-2013-132231 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1546214377</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4026305311</sourcerecordid><originalsourceid>FETCH-LOGICAL-b420t-f7ad33de92726ec187cc3c562aed80235a5f1ff4f71a888d2cdf06cbe4cdebb13</originalsourceid><addsrcrecordid>eNqNkE1r3DAQQEVJ6G7S_oUiyKUXpxpJtry5ldAmhUAuWejNyNJoV4ttOZJ86L-Plk1K6SmngZk3X48QCuwaQDTf5pDyLmo7oj1UnIGoQHAu4ANZg2w2FVN1c0bWjAle1VKJFblI6cAKqCR8JCsu240UINfk93aeMdKdTjkGP2VM2U96oP2AaP20o36i-5Bmn0vST7POHqecbmjeI41hQBoc1VP2eR_D2IfsDbVx2aVP5NzpIeHn13hJtj9_PN3eVw-Pd79uvz9UveQsV05pK4TFDVe8QQOtMkaYuuEabcu4qHXtwDnpFOi2bS031rHG9CiNxb4HcUm-nubOMTwv5fxu9MngMOgJw5I6qGXDQQqlCnr1H3oISyzfFkq10NQ1k7JQ7YkyMaQU0XVz9KOOfzpg3dF-96_97mi_O9kvrV9eFyx9Kf5tfNNdAHEC-vHw_rEvuVGXBA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1781655044</pqid></control><display><type>article</type><title>Upper gastrointestinal bleeding in hospital inpatients: the role of antithrombotic drugs</title><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><source>BMJ Journals - NESLi2</source><creator>Taha, Ali S ; Kelly, Claire ; McCloskey, Caroline ; Craigen, Theresa ; Angerson, Wilson J</creator><creatorcontrib>Taha, Ali S ; Kelly, Claire ; McCloskey, Caroline ; Craigen, Theresa ; Angerson, Wilson J</creatorcontrib><description>Background Critically ill patients are considered to be most at risk from developing non-variceal upper gastrointestinal bleeding (NVGIB) while in hospital. The increasing prescription of low-dose aspirin and other antithrombotic drugs for protection against thromboembolism to many patients admitted to hospital may increase the vulnerability of a wider group to NVGIB. Objective This study compares two groups of patients with NVGIB: group I, inpatients cared for outside the intensive care unit; and group II, patients admitted with this condition, while considering the use of antithrombotic drugs. Methods We identified all patients who developed NVGIB in the two calendar years between 2008 and 2009 and compared group I with group II while taking into account their clinical details including Rockall scores and drug usage. Results Compared with group II (n=274), group I (n=96) were older (median age of 77 years vs 68; p<0.001), had fewer males (45.8% vs 60.6%; p=0.016), higher prevalence of cardiovascular disease (52.1% vs 29.2%; p<0.001), more patients with complete Rockall score ≥3 (84.4% vs 66.7%; p=0.001) and more patients treated with aspirin or other antithrombotic drugs (64.6% vs 44.5%; p=0.001). After adjustment for age and sex, group I were still significantly more likely to be taking antithrombotic drugs than group II (OR (95% CIs), 2.15 (1.25 to 3.68); p=0.006). The endoscopic abnormalities in more than 80% of patients included erosive oesophagitis, gastric or duodenal ulcers or erosions. Conclusions Subjects who develop NVGIB as inpatients have higher Rockall scores are mainly older females with cardiovascular disease and using antithrombotic drugs. Secondary care clinicians should be mindful of this at-risk group of patients and consider giving them prophylactic antiulcer therapy.</description><identifier>ISSN: 0032-5473</identifier><identifier>EISSN: 1469-0756</identifier><identifier>DOI: 10.1136/postgradmedj-2013-132231</identifier><identifier>PMID: 24894314</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Age Factors ; Aged ; Anti-Ulcer Agents - therapeutic use ; Anticoagulants - adverse effects ; Aspirin ; Blood Transfusion - statistics & numerical data ; Blood transfusions ; Cardiovascular disease ; Drug Administration Schedule ; Drug dosages ; Endoscopy ; Epidemiology ; Female ; Gastroenterology ; Gastrointestinal Hemorrhage - chemically induced ; Gastrointestinal Hemorrhage - epidemiology ; Gastrointestinal Hemorrhage - prevention & control ; Hemorrhage ; Hospitals ; Humans ; Inpatients - statistics & numerical data ; Intensive care ; Male ; Medical imaging ; Middle Aged ; Mortality ; Platelet Aggregation Inhibitors - adverse effects ; Risk Factors ; Stomach Ulcer - chemically induced ; Stomach Ulcer - epidemiology ; Stomach Ulcer - prevention & control ; Ulcers</subject><ispartof>Postgraduate medical journal, 2014-08, Vol.90 (1066), p.429-433</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>Copyright: 2014 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b420t-f7ad33de92726ec187cc3c562aed80235a5f1ff4f71a888d2cdf06cbe4cdebb13</citedby><cites>FETCH-LOGICAL-b420t-f7ad33de92726ec187cc3c562aed80235a5f1ff4f71a888d2cdf06cbe4cdebb13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://pmj.bmj.com/content/90/1066/429.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttps://pmj.bmj.com/content/90/1066/429.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,776,780,3183,23550,27901,27902,77343,77374</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24894314$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Taha, Ali S</creatorcontrib><creatorcontrib>Kelly, Claire</creatorcontrib><creatorcontrib>McCloskey, Caroline</creatorcontrib><creatorcontrib>Craigen, Theresa</creatorcontrib><creatorcontrib>Angerson, Wilson J</creatorcontrib><title>Upper gastrointestinal bleeding in hospital inpatients: the role of antithrombotic drugs</title><title>Postgraduate medical journal</title><addtitle>Postgrad Med J</addtitle><description>Background Critically ill patients are considered to be most at risk from developing non-variceal upper gastrointestinal bleeding (NVGIB) while in hospital. The increasing prescription of low-dose aspirin and other antithrombotic drugs for protection against thromboembolism to many patients admitted to hospital may increase the vulnerability of a wider group to NVGIB. Objective This study compares two groups of patients with NVGIB: group I, inpatients cared for outside the intensive care unit; and group II, patients admitted with this condition, while considering the use of antithrombotic drugs. Methods We identified all patients who developed NVGIB in the two calendar years between 2008 and 2009 and compared group I with group II while taking into account their clinical details including Rockall scores and drug usage. Results Compared with group II (n=274), group I (n=96) were older (median age of 77 years vs 68; p<0.001), had fewer males (45.8% vs 60.6%; p=0.016), higher prevalence of cardiovascular disease (52.1% vs 29.2%; p<0.001), more patients with complete Rockall score ≥3 (84.4% vs 66.7%; p=0.001) and more patients treated with aspirin or other antithrombotic drugs (64.6% vs 44.5%; p=0.001). After adjustment for age and sex, group I were still significantly more likely to be taking antithrombotic drugs than group II (OR (95% CIs), 2.15 (1.25 to 3.68); p=0.006). The endoscopic abnormalities in more than 80% of patients included erosive oesophagitis, gastric or duodenal ulcers or erosions. Conclusions Subjects who develop NVGIB as inpatients have higher Rockall scores are mainly older females with cardiovascular disease and using antithrombotic drugs. Secondary care clinicians should be mindful of this at-risk group of patients and consider giving them prophylactic antiulcer therapy.</description><subject>Age Factors</subject><subject>Aged</subject><subject>Anti-Ulcer Agents - therapeutic use</subject><subject>Anticoagulants - adverse effects</subject><subject>Aspirin</subject><subject>Blood Transfusion - statistics & numerical data</subject><subject>Blood transfusions</subject><subject>Cardiovascular disease</subject><subject>Drug Administration Schedule</subject><subject>Drug dosages</subject><subject>Endoscopy</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Gastrointestinal Hemorrhage - chemically induced</subject><subject>Gastrointestinal Hemorrhage - epidemiology</subject><subject>Gastrointestinal Hemorrhage - prevention & control</subject><subject>Hemorrhage</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Inpatients - statistics & numerical data</subject><subject>Intensive care</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Platelet Aggregation Inhibitors - adverse effects</subject><subject>Risk Factors</subject><subject>Stomach Ulcer - chemically induced</subject><subject>Stomach Ulcer - epidemiology</subject><subject>Stomach Ulcer - prevention & control</subject><subject>Ulcers</subject><issn>0032-5473</issn><issn>1469-0756</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkE1r3DAQQEVJ6G7S_oUiyKUXpxpJtry5ldAmhUAuWejNyNJoV4ttOZJ86L-Plk1K6SmngZk3X48QCuwaQDTf5pDyLmo7oj1UnIGoQHAu4ANZg2w2FVN1c0bWjAle1VKJFblI6cAKqCR8JCsu240UINfk93aeMdKdTjkGP2VM2U96oP2AaP20o36i-5Bmn0vST7POHqecbmjeI41hQBoc1VP2eR_D2IfsDbVx2aVP5NzpIeHn13hJtj9_PN3eVw-Pd79uvz9UveQsV05pK4TFDVe8QQOtMkaYuuEabcu4qHXtwDnpFOi2bS031rHG9CiNxb4HcUm-nubOMTwv5fxu9MngMOgJw5I6qGXDQQqlCnr1H3oISyzfFkq10NQ1k7JQ7YkyMaQU0XVz9KOOfzpg3dF-96_97mi_O9kvrV9eFyx9Kf5tfNNdAHEC-vHw_rEvuVGXBA</recordid><startdate>20140801</startdate><enddate>20140801</enddate><creator>Taha, Ali S</creator><creator>Kelly, Claire</creator><creator>McCloskey, Caroline</creator><creator>Craigen, Theresa</creator><creator>Angerson, Wilson J</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20140801</creationdate><title>Upper gastrointestinal bleeding in hospital inpatients: the role of antithrombotic drugs</title><author>Taha, Ali S ; Kelly, Claire ; McCloskey, Caroline ; Craigen, Theresa ; Angerson, Wilson J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b420t-f7ad33de92726ec187cc3c562aed80235a5f1ff4f71a888d2cdf06cbe4cdebb13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Age Factors</topic><topic>Aged</topic><topic>Anti-Ulcer Agents - therapeutic use</topic><topic>Anticoagulants - adverse effects</topic><topic>Aspirin</topic><topic>Blood Transfusion - statistics & numerical data</topic><topic>Blood transfusions</topic><topic>Cardiovascular disease</topic><topic>Drug Administration Schedule</topic><topic>Drug dosages</topic><topic>Endoscopy</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Gastrointestinal Hemorrhage - chemically induced</topic><topic>Gastrointestinal Hemorrhage - epidemiology</topic><topic>Gastrointestinal Hemorrhage - prevention & control</topic><topic>Hemorrhage</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Inpatients - statistics & numerical data</topic><topic>Intensive care</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Platelet Aggregation Inhibitors - adverse effects</topic><topic>Risk Factors</topic><topic>Stomach Ulcer - chemically induced</topic><topic>Stomach Ulcer - epidemiology</topic><topic>Stomach Ulcer - prevention & control</topic><topic>Ulcers</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Taha, Ali S</creatorcontrib><creatorcontrib>Kelly, Claire</creatorcontrib><creatorcontrib>McCloskey, Caroline</creatorcontrib><creatorcontrib>Craigen, Theresa</creatorcontrib><creatorcontrib>Angerson, Wilson J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Postgraduate medical journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Taha, Ali S</au><au>Kelly, Claire</au><au>McCloskey, Caroline</au><au>Craigen, Theresa</au><au>Angerson, Wilson J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Upper gastrointestinal bleeding in hospital inpatients: the role of antithrombotic drugs</atitle><jtitle>Postgraduate medical journal</jtitle><addtitle>Postgrad Med J</addtitle><date>2014-08-01</date><risdate>2014</risdate><volume>90</volume><issue>1066</issue><spage>429</spage><epage>433</epage><pages>429-433</pages><issn>0032-5473</issn><eissn>1469-0756</eissn><abstract>Background Critically ill patients are considered to be most at risk from developing non-variceal upper gastrointestinal bleeding (NVGIB) while in hospital. The increasing prescription of low-dose aspirin and other antithrombotic drugs for protection against thromboembolism to many patients admitted to hospital may increase the vulnerability of a wider group to NVGIB. Objective This study compares two groups of patients with NVGIB: group I, inpatients cared for outside the intensive care unit; and group II, patients admitted with this condition, while considering the use of antithrombotic drugs. Methods We identified all patients who developed NVGIB in the two calendar years between 2008 and 2009 and compared group I with group II while taking into account their clinical details including Rockall scores and drug usage. Results Compared with group II (n=274), group I (n=96) were older (median age of 77 years vs 68; p<0.001), had fewer males (45.8% vs 60.6%; p=0.016), higher prevalence of cardiovascular disease (52.1% vs 29.2%; p<0.001), more patients with complete Rockall score ≥3 (84.4% vs 66.7%; p=0.001) and more patients treated with aspirin or other antithrombotic drugs (64.6% vs 44.5%; p=0.001). After adjustment for age and sex, group I were still significantly more likely to be taking antithrombotic drugs than group II (OR (95% CIs), 2.15 (1.25 to 3.68); p=0.006). The endoscopic abnormalities in more than 80% of patients included erosive oesophagitis, gastric or duodenal ulcers or erosions. Conclusions Subjects who develop NVGIB as inpatients have higher Rockall scores are mainly older females with cardiovascular disease and using antithrombotic drugs. Secondary care clinicians should be mindful of this at-risk group of patients and consider giving them prophylactic antiulcer therapy.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>24894314</pmid><doi>10.1136/postgradmedj-2013-132231</doi><tpages>5</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0032-5473 |
| ispartof | Postgraduate medical journal, 2014-08, Vol.90 (1066), p.429-433 |
| issn | 0032-5473 1469-0756 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1546214377 |
| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; BMJ Journals - NESLi2 |
| subjects | Age Factors Aged Anti-Ulcer Agents - therapeutic use Anticoagulants - adverse effects Aspirin Blood Transfusion - statistics & numerical data Blood transfusions Cardiovascular disease Drug Administration Schedule Drug dosages Endoscopy Epidemiology Female Gastroenterology Gastrointestinal Hemorrhage - chemically induced Gastrointestinal Hemorrhage - epidemiology Gastrointestinal Hemorrhage - prevention & control Hemorrhage Hospitals Humans Inpatients - statistics & numerical data Intensive care Male Medical imaging Middle Aged Mortality Platelet Aggregation Inhibitors - adverse effects Risk Factors Stomach Ulcer - chemically induced Stomach Ulcer - epidemiology Stomach Ulcer - prevention & control Ulcers |
| title | Upper gastrointestinal bleeding in hospital inpatients: the role of antithrombotic drugs |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-30T07%3A52%3A57IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Upper%20gastrointestinal%20bleeding%20in%20hospital%20inpatients:%20the%20role%20of%20antithrombotic%20drugs&rft.jtitle=Postgraduate%20medical%20journal&rft.au=Taha,%20Ali%20S&rft.date=2014-08-01&rft.volume=90&rft.issue=1066&rft.spage=429&rft.epage=433&rft.pages=429-433&rft.issn=0032-5473&rft.eissn=1469-0756&rft_id=info:doi/10.1136/postgradmedj-2013-132231&rft_dat=%3Cproquest_cross%3E4026305311%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1781655044&rft_id=info:pmid/24894314&rfr_iscdi=true |