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July 26, 1993Archives of Internal Medicine

Concurrent Use of Nonsteroidal Anti-inflammatory Drugs and Oral Anticoagulants Places Elderly Persons at High Risk for Hemorrhagic Peptic Ulcer Disease

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Why the study?

Does concurrent use of NSAIDs and oral anticoagulants increase the risk of hemorrhagic peptic ulcer disease in elderly persons?

Population

103,954 Tennessee Medicaid enrollees aged 65 years or older

Comparison

Concurrent use of oral anticoagulants and… vs Nonusers of either drug

Design

Cohort

Follow-up

209,066 person-years total (1984 through 1986)

Key result

Concurrent use of oral anticoagulants and NSAIDs in elderly persons increased the risk of hemorrhagic peptic ulcer disease nearly 13-fold compared to nonusers (RR 12.7; 95% CI 6.3 to 25.7).

Authors

RSRonald I. Shorr

Discussion

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Overview

Associated with high hemorrhagic ulcer risk in elderly anticoagulant users; leaves open need for randomized confirmation and mitigation strategies.

Study Design

Type

Cohort (n=103,954)

Structured PICO

Does concurrent use of NSAIDs and oral anticoagulants increase the risk of hemorrhagic peptic ulcer disease in elderly persons?

P
Population
103,954 Tennessee Medicaid enrollees aged 65 years or older
I
Intervention
Concurrent use of oral anticoagulants and nonsteroidal anti-inflammatory drugs (NSAIDs)
C
Comparator
Nonusers of either drug
O
Outcome
Hospitalization for hemorrhagic peptic ulcer disease (presenting with frank hematemesis or melena)safety

Main Result

Effect estimate: RR 12.7 (95% CI 6.3 to 25.7)

Concurrent use of oral anticoagulants and NSAIDs in elderly patients is associated with a nearly 13-fold increased risk of hemorrhagic peptic ulcer disease, highlighting the need for extreme caution when co-prescribing these medications.

Cite This Study

Ronald I. Shorr (1993) conducted a cohort in Hemorrhagic peptic ulcer disease (n=103,954). Concurrent use of oral anticoagulants and NSAIDs vs. Nonusers of either drug was evaluated on Hemorrhagic peptic ulcer disease (RR 12.7, 95% CI 6.3 to 25.7). Concurrent use of oral anticoagulants and NSAIDs in elderly persons increased the risk of hemorrhagic peptic ulcer disease nearly 13-fold compared to nonusers (RR 12.7; 95% CI 6.3 to 25.7).

synapsesocial.com/papers/6a0835b8ab15ea61dee8b90ehttps://doi.org/10.1001/archinte.1993.00410140047006
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