A cohort study (with re-sampled comparator groups) to measure the association between new NSAID prescribing and upper gastrointestinal hemorrhage and perforation

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Abstract

This cohort study examined the relationship between newly prescribed NSAIDs (none in the previous six months) and upper gastrointestinal hemorrhage and perforation in Tayside, Scotland. Exposure was classified by prescription duration. The study population consisted of the population of Tayside. A Comparator Group was chosen at random (within age and sex strata). Two hundred re-sampled comparator groups were created. Statistical analyses were carried out by Poisson regression (repeated for each of the re-samples). The analyses controlled for age, sex, prior hospitalization for upper gastrointestinal events, prior endoscopy, and the use of ulcer healing drugs. There were 78,191 subjects in the NSAID group, and 78,207 in each of the comparator groups. The increased risk with NSAIDs was only apparent for subjects without a history of upper gastrointestinal events; univariate rate ratio = 2.76 (1.90, 4.01). The final, re-sampled estimate of NSAID risk was rate ratio = 2.48 (1.87, 3.29).

References (11)

  • J Laporte et al.

    Upper gastrointestinal bleeding in relation to previous use of analgesics and non-steroidal anti-inflammatory drugs

    Lancet

    (1991)
  • DA Henry

    Gastrointestinal bleeding and nonsteroidal anti-inflammatory drugs

    Current Med

    (1994)
  • P Bollini et al.

    The impact of research quality and study design on epidemiologic estimates of the effect of nonsteroidal anti-inflammatory drugs on upper gastrointestinal tract disease

    Arch Intern Med

    (1992)
  • TM MacDonald et al.

    The Tayside Medicines Monitoring Unit

  • S Dornan et al.

    Assessment of the accuracy of upper gastrointestinal diagnoses in Scottish Morbidity Record 1 data in Tayside

    Health Bulletin

    (1995)
There are more references available in the full text version of this article.

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The Medicines Monitoring Unit is supported by the Medicines Control Agency. The present study was funded in part by a grant from Glaxo-Wellcome PLC. There were no conflicts of interest.

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