文档介绍：NSAIDs and GI and plications
Lessons from Tennessee Medicaid population studies
(and selected others)
Overview
Upper plications of NSAIDs
Age
Dose/duration
Corticosteroids
Coumadin
plications
Other
Age-specific peptic ulcer hospitalization rates by sex and NSAID use, Saskatchewan, 1982-1986
Female nonusers
Male nonusers
Female users
Male users
15
20
25
30
35
40
45
50
55
60
65
70
75
80
85+ Age
20
15
10
5
0
25
Hospitalizations per 1,000 person-years
Garcia Rodriguez et al, Epidemiology 1992
Hospitalizations for PUD Tennessee Medicaid, age 65+, 1984-86
Griffin et al Ann Intern Med 1991
plications meta-analysis: 5 studies that included dose
Henry et al Br Med J 1996
Hospitalizations for PUD Tennessee Medicaid, age 65+, 1984-86
Smalley et al Am J Epidemiol 1995
Corticosteroids and NSAIDs
Co-prescription 1-3% of elderly
Similar to non-NSAID users
Increases risk 13-15 fold over non-users
Ulcer hospitalization: 5-6 per 100 per year
Coumadin and NSAIDs
Co-prescription 1-2% of elderly
Similar to non-NSAID users
Increases risk of GI bleeding 12 fold over non-users
Ulcer hospitalization: 3 per 100 per year
NSAIDs and Acute Renal Failure, Tennessee Medicaid, aged 65+, 1987-1991
1799 munity acquired ARF
hospitalization per 1000 person-years
Median length of stay 8 days
3% dialysis
30 day mortality 36%