[Accumulation of risk factors before acute gastroduodenal hemorrhage: analgesic/antirheumatic drugs, alcohol and ulcer anamnesis].
الكلمات الدالة
نبذة مختصرة
72 patients with acute hemorrhage from gastroduodenal peptic lesions were asked about their drug and alcohol consumption as well as about their smoking habits, 43 of them (60%) had used analgetic or antiinflammatory drugs on at least 3 days during the week preceding the gastrointestinal (g. i.) hemorrhage, 20 patients had used more than on drug, 4 patients an overdose of one drug. During a therapy with corticosteroids alone only one thrombopenic patient bled. 21 patients (29%) had an abnormal high alcohol consumption. In the control group significantly fewer patients had such a drug and alcohol history (p less than 0.01 and p less than 0.05, respectively). The relative risk of a g. i. hemorrhage following an exposition with analgetic/antiinflammatory drugs was RR = +7.41 +/- 5.8. Strikingly, 43 patients (60%) had an ulcer history or a g.i. hemorrhage in the past. In 46 per cent of all patients the risk factors analgesic/antiinflammatory drug, alcohol and ulcer history accumulated before the acute hemorrhage. A more careful indication and dosage of analgesic and antiinflammatory drug therapy might reduce the frequency of g.i. hemorrhage. Most of the patients were male (76%). 39 patients (54%) were older than 60 years. The average age of the 6 patients who died was 73 +/- 6.3 years. After analgesic/antiinflammatory treatment the clinical course was by no means better than in the case of spontaneously occurring lesions. Endoscopically, following exposition with analgesic/antiinflammatory drugs more frequently erosions (p less than 0.05), multiple ulcers and gastric ulcers (no statistical significance) were observed.