Upper Gastrointestinal Bleed Induced By Non-Steroidal Anti-Inflammatory Drugs/Aspirin In Jamaica

Background: Gastrointestinal disturbances are the most common adverse effects of NSAIDs and ASA. Upper gastrointestinal bleeding (UGIB) occurs in over 2-4% of NSAIDs/ASA users. Objectives: To review patients admitted with upper gastrointestinal bleed induced by NSAIDs/ASA at the University hospital of the West Indies between January 2001 to December 2007. Methods: Patients admitted between January 2001 to December 2007 with upper gastrointestinal bleed caused by NSAIDs/ASA were reviewed. Data regarding age, gender, hospital stay and drugs used were obtained. Descriptive frequency statistics was used to analyse the data collected. Results: Of 88 patients reviewed, 46 (24 females and 22 males) were admitted with UGI bleed induced by NSAIDs/ASA and 42 patients (13 females and 29 males) had non-NSAIDs/ASA induced UGIB. The mean age in the NSAIDs/ASA induced UGI haemorrhage group was significantly older compared to the non-NSAIDs/ASA group (62 vs 51 years). The patients hospitalized for NSAIDs/ASA induced UGIB had significantly shorter hospital stays being 3.48 times more likely (95% CI= 1.27-9.56; Z= 2.42, p <0.05) to be hospitalized for 1-3 days than non-NSAIDs/ASA patients. Aspirin and diclofenac were most frequently implicated followed by ibuprofen and indomethacin, mefenamic acid, piroxicam and rofecoxib. Conclusions: NSAID/ASA induced UGI bleeding occurred in older patients. Hospital stay in the NSAID/ASA group was shorter. Aspirin and diclofenac are responsible for majority of the drug induced haemorrhages that occurred.