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Wiley InterScience

The American Journal of Gastroenterology

The American Journal of Gastroenterology

Volume 100 Issue 8, Pages 1685 - 1693

Published Online: 8 Aug 2005

© 2008 American College of Gastroenterology/Blackwell Publishing



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A Nationwide Study of Mortality Associated with Hospital Admission Due to Severe Gastrointestinal Events and Those Associated with Nonsteroidal Antiinflammatory Drug Use
Angel Lanas, M.D. 1 , Maria Angeles Perez-Aisa, M.D. 1 , Faust Feu, M.D. 2 , Julio Ponce, M.D. 3 , Esteban Saperas, M.D. 4 , Santos Santolaria, M.D. 5 , Luis Rodrigo, M.D. 6 , Joaquim Balanzo, M.D. 7 , Eduardo Bajador, M.D. 8 , Pedro Almela, M.D. 9 , Jose M. Navarro, M.D. 10 , Fernando Carballo, M.D. 11 , Manuel Castro, M.D. 12 , and Enrique Quintero, M.D. 13 , on behalf of the Investigators of the Asociación Española de Gastroenterología (AEG)
  1 Servicio de Aparato Digestivo, Hospital Clínico Zaragoza, Zaragoza ;   2 Servicio de Aparato Digestivo, Hospital Clinico de Barcelona ;   3 Servicio de Aparato Digestivo Hospital La Fe, Valencia ;   4 Servicio de Aparato Digestivo, Hospital Val'de Hebron, Barcelona ;   5 Servicio de Aparato Digestivo, Hospital San Jorge, Huesca ;   6 Servicio de Aparato Digestivo, Hospital de Asturias, Oviedo ;   7 Servicio de Aparato Digestivo, Hospital de San Pau, Barcelona ;   8 Servicio de Aparato Digestivo, Hospital Miguel Server, Zaragoza ;   9 Servicio de Aparato Digestivo, Hospital Clínico, Valencia ;   10 Servicio de Aparato Digestivo, Hospital Costa del Sol, Marbella ;   11 Servicio de Aparato Digestivo, Hospital Universitario de Guadalajara ;   12 Servicio de Aparato Digestivo, Hospital del Valme, Sevilla ; and   13 Servicio de Aparato Digestivo, Hospital Universitario de la Laguna, Tenerife, Spain
  Reprint requests and correspondence: Angel Lanas, M.D., Service of Gastroenterology, University Hospital, Lozano Blesa, 50009 Zaragoza, Spain.

For the list of the members of Asociación Española de Gastroenterología, see Appendix.

Copyright 2005 by the American College of Gastroenterology

(Am J Gastroenterol 2005;100:1685–1693)

ABSTRACT

BACKGROUND:  The worst outcome of gastrointestinal complications is death. Data regarding those associated with nonsteroidal antiinflammatory drug (NSAID) or aspirin use are scarce.

AIM:  To determine mortality associated with hospital admission due to major gastrointestinal (GI) events and NSAID/aspirin use.

METHODS:  The study was based on actual count of deaths from two different data sets from 2001. Study 1 was carried out in 26 general hospitals serving 7,901,198 people. Study 2 used a database from 197 general hospitals, representative of the 269 hospitals in the Spanish National Health System. Information regarding gastrointestinal complications and deaths was obtained throughout the Minimum Basic Data Set (CIE-9-MC) provided by participating hospitals. Deaths attributed to NSAID/aspirin use were estimated on the basis of prospectively collected data from hospitals of study 1.

RESULTS:  The incidence of hospital admission due to major GI events of the entire (upper and lower) gastrointestinal tract was 121.9 events/100,000 persons/year, but those related to the upper GI tract were six times more frequent. Mortality rate was 5.57% (95% CI = 4.9–6.7), and 5.62% (95% CI = 4.8–6.8) in study 1 and study 2, respectively. Death rate attributed to NSAID/aspirin use was between 21.0 and 24.8 cases/million people, respectively, or 15.3 deaths/100,000 NSAID/aspirin users. Up to one-third of all NSAID/aspirin deaths can be attributed to low-dose aspirin use.

CONCLUSION:  Mortality rates associated with either major upper or lower GI events are similar but upper GI events were more frequent. Deaths attributed to NSAID/ASA use were high but previous reports may have provided an overestimate and one-third of them can be due to low-dose aspirin use.


Received November 19, 2004; accepted March 1, 2005.

DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1572-0241.2005.41833.x About DOI

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