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Titolo:
Effect of nonsteroidal anti-inflammatory drug use on the rate of gastrointestinal hospitalizations among people living in long-term care
Autore:
Lapane, KL; Spooner, JJ; Mucha, L; Straus, WL;
Indirizzi:
Brown Univ, Ctr Gerontol & Hlth Care Res, Providence, RI 02912 USA Brown Univ Providence RI USA 02912 lth Care Res, Providence, RI 02912 USA Brown Univ, Sch Med, Dept Community Hlth, Providence, RI 02912 USA Brown Univ Providence RI USA 02912 mmunity Hlth, Providence, RI 02912 USA Merck & Co Inc, W Point, PA USA Merck & Co Inc W Point PA USAMerck & Co Inc, W Point, PA USA
Titolo Testata:
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
fascicolo: 5, volume: 49, anno: 2001,
pagine: 577 - 584
SICI:
0002-8614(200105)49:5<577:EONADU>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
NURSING-HOME RESIDENTS; PEPTIC-ULCER DISEASE; MINIMUM DATA SET; ANTIINFLAMMATORY DRUGS; GERIATRIC PHARMACOEPIDEMIOLOGY; ELDERLY PATIENTS; RISK-FACTORS; COMPLICATIONS; TOXICITY; METAANALYSIS;
Keywords:
nonsteroidal anti-inflammatory agents; gastrointestinal events; nursing homes; pharmacoepidemiology;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Social & Behavioral Sciences
Clinical Medicine
Citazioni:
50
Recensione:
Indirizzi per estratti:
Indirizzo: Lapane, KL Brown Univ, Ctr Gerontol & Hlth Care Res, Box G-B222,171 Meeting St, Providence, RI 02912 USA Brown Univ Box G-B222,171 Meeting St Providence RI USA 02912 SA
Citazione:
K.L. Lapane et al., "Effect of nonsteroidal anti-inflammatory drug use on the rate of gastrointestinal hospitalizations among people living in long-term care", J AM GER SO, 49(5), 2001, pp. 577-584

Abstract

OBJECTIVES: Gastrointestinal (GI) complications are the most-common serious adverse reactions associated with nonsteroidal anti-inflammatory drugs (NSAIDs). We quantified the effect of specific NSAIDs on the rate of GI hospitalizations among older people living in long-term care. DESIGN: Retrospective cohort study. SETTING;: All Medicare/Medicaid certified nursing homes in four states (Maine, Minnesota, New York, and South Dakota). PARTICIPANTS: We identified 125,516 newly admitted residents from a database of all residents (1992-1996) of all Medicare/Medicaid certified nursing homes in four states. Using the federally mandated Minimum Data Set, which includes information on all drugs received (prescription and over-the-counter), we identified patients who received at least one prescription for aspirin (n = 19,101) or NSAIDs (n = 9,777). The control population consisted ofall institutionalized persons who did not receive these drugs. MEASUREMENTS: From Health Care Financing Administration inpatient claims, we identified the first hospitalization for GI perforation, ulcer, or hemorrhage that occurred during the year of follow up (ICD9-CM discharge codes: 531-534, 578). Cox proportional hazards models provided adjusted estimates of rate ratios. RESULTS: NSAID exposure increased the GI-event-related hospitalization rate in both men (rate ratios (RR) = 2.64; 95% confidence interval (CI) = 1.17-5.99) and women (RR = 3.23; 95% CI = 1.85-5.65). The race of GI hospitalizations for both men and women taking sulindac, naproxen, or indomethacin was higher than for nonusers. The risk of GI-event-related hospitalizations was greatest among women exposed to diflunisal (RR = 6.08; 95% CI = 2.27-16.26) or oxaprozin (RR = 6.03; 95% CI = 2.4914.58). CONCLUSIONS: Despite the high background rate of GI events, most NSAIDs increased the risk of GI hospitalization. Careful attention to choice of agent and dosing is needed in prescribing NSAIDs in this frail, older population.

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Documento generato il 17/02/20 alle ore 17:19:02