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Hemorragia digestiva alta associada ao consumo de ácido acetilsalicílico e de anti-inflamatórios n?o-esteróides em Portugal Resultados do estudo PARAINES

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Abstract:

introduction: acetylsalicylic acid (asa) and non-steroidal anti-inflammatory drugs (nsaids) are amongst the most prescribed drugs in the world and may lead to peptic ulcer related bleeding and death. patients and methods: paraines study was a multicentre and retrospective study whose objective was to characterize the magnitude and management of asa/nsaids related upper gastrointestinal bleeding in portugal (9 centres; referral population 2.5 million) in 2006. results: we report 291 hospitalizations for 280 patients (estimated incidence 145.5/100000 asa/nsaids consumers/year). two thirds were male; 68.7% were older than 65 years and 24.1% had a previous history of peptic ulcer. low-dose asa was the most prescribed drug. fifteen per cent of the patients with gastrointestinal risk were taking a proton pump inhibitor for gastric protection. 237 peptic ulcers were diagnosed, 51% with endoscopic high-risk stigmata, usually treated with dual injection therapy (77.2%) and iv proton pump inhibitors (33% high dose continuous infusion). ten patients died during hospitalization (3.6%; estimated incidence 5/100000 asa/nsaids consumers/year). conclusions: hospitalization and in-hospital mortality incidence of asa/nsaids related upper gastrointestinal bleeding in portugal were lower than expected; only a few patients with associated risk factors are actually on proton pump inhibitors prophylaxis; peptic ulcer bleeding treatment may be further optimized.

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