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A model to predict the risk of aspirin/non‐steroidal anti‐inflammatory drugs‐related upper gastrointestinal bleeding for the individual patient
Author(s) -
Petersen Jóhanna,
Møller Hansen Jane,
Muckadell Ove B. Schaffalitzky,
Dall Michael,
Hallas Jesper
Publication year - 2020
Publication title -
basic and clinical pharmacology and toxicology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.805
H-Index - 90
eISSN - 1742-7843
pISSN - 1742-7835
DOI - 10.1111/bcpt.13370
Subject(s) - aspirin , medicine , incidence (geometry) , population , upper gastrointestinal bleeding , regimen , gastroenterology , endoscopy , physics , environmental health , optics
Upper gastrointestinal bleeding is a feared complication of using non‐steroidal anti‐inflammatory drugs (NSAIDs) or aspirin. Studies predicting the incidence rate for individuals with a given set of characteristics are lacking. The aim of this study was to develop a risk model to predict the incidence rate of upper gastrointestinal bleeding (UGIB) in users of aspirin/NSAID based on presence of well‐defined risk factors for the individual patient. Methods The model was developed from data from a case‐control study, sampled from a well‐defined source population, residents of the Funen County 1995‐2006. All cases and controls were characterized in terms of factors known to affect the risk of UGIB. By using census data, we rescaled the control group, so their composition accurately reflected age and sex distribution of the source population. Only persons using NSAIDs or/and aspirin and no PPI were included in the analysis. As reference group, we chose 80‐ to 89‐year‐old women with no ulcer history, using NSAID, but neither aspirin, other platelet inhibitors, vitamin K antagonists, selective serotonin reuptake inhibitors nor corticosteroids. Results We identified 1388 cases among non‐users of PPIs. We found a modelled baseline incidence rate of 10.7 per 1000 person‐years for the reference group. The strongest associations were found for ADP inhibitors (OR 5.80), followed by anticoagulants treatment (OR 2.62) and prior ulcer (OR 2.68). The model performed well in terms of calibration and discriminatory power. Conclusion This study is the first to describe a model, which estimates the incidence rate of UGIB for patients using aspirin/NSAID, based on the specific combination of risk factors. Risk of upper gastrointestinal bleeding for a given patient can be accurately estimated using this model.