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首页> 外文期刊>Rheumatology >Hospitalization for gastrointestinal bleeding associated with non-steroidal anti-inflammatory drugs among elderly patients using low-dose aspirin: a retrospective cohort study.
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Hospitalization for gastrointestinal bleeding associated with non-steroidal anti-inflammatory drugs among elderly patients using low-dose aspirin: a retrospective cohort study.

机译：使用低剂量阿司匹林的老年患者因非甾体类抗炎药引起的胃肠道出血住院治疗：一项回顾性队列研究。

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OBJECTIVES: Many elderly patients are prescribed both low-dose aspirin (ASA), for cardiovascular protection and non-steroidal anti-inflammatory drugs (NSAIDs) for pain control. Compared with non-selective NSAIDs (NS-NSAIDs), celecoxib has a superior gastrointestinal (GI) safety profile in general. It is unclear, however, whether this fact holds good among patients taking ASA. We compared GI hospitalization rates among elderly patients taking celecoxib, NS-NSAIDs, celecoxib and ASA or NS-NSAIDs and ASA. METHODS: This was a retrospective cohort study using Quebec government databases. All patients 65 yrs of age or older who filled a prescription for celecoxib or an NS-NSAID between April 1999 and December 2002 were included. Cox regression models were used to compare the GI hospitalization rates between the four exposure categories adjusting for potential confounders. RESULTS: A total of 332 491 patients were included. Among 1 522 307 celecoxib prescriptions, 430 214 were filled by patients concurrently receiving ASA (celecoxib and ASA); 195 369 of 863 646 NS-NSAID prescriptions were filled by patients receiving ASA (NS-NSAID and ASA). Celecoxib without ASA was less likely than NS-NSAID without ASA to be associated with GI hospitalization [hazard ratio (HR) 0.41, 95% confidence interval (CI) 0.33-0.50]; celecoxib and ASA was also less likely to be associated with GI hospitalization than NS-NSAID and ASA (HR 0.62, 95% CI 0.48-0.80); GI hospitalization rates were similar for celecoxib and ASA and NS-NSAID without ASA (HR 1.01, 95% CI 0.81-1.25). CONCLUSION: Among elderly patients receiving cardiovascular protection with ASA and pain control with anti-inflammatory drugs, celecoxib may be safer with regards to GI toxicity than NS-NSAIDs.
机译：目的：许多老年患者都接受低剂量阿司匹林（ASA）治疗心血管疾病和非甾体抗炎药（NSAIDs）治疗疼痛。与非选择性NSAIDs（NS-NSAIDs）相比，塞来昔布通常具有更好的胃肠道（GI）安全性。但是，目前尚不清楚在使用ASA的患者中这一事实是否成立。我们比较了接受塞来昔布，NS-NSAID，塞来昔布和ASA或NS-NSAID和ASA的老年患者的胃肠道住院率。方法：这是一项使用魁北克政府数据库的回顾性队列研究。纳入了所有在1999年4月至2002年12月之间接受塞来昔布或NS-NSAID处方的65岁以上患者。使用Cox回归模型比较调整了潜在混杂因素的四个暴露类别之间的GI住院率。结果：总共包括332491例患者。在1 522 307塞来昔布处方中，有430 214的患者同时接受ASA（塞来昔布和ASA）治疗;接受ASA的患者（NS-NSAID和ASA）填写了863646个NS-NSAID处方中的195369个。与没有ASA的NS-NSAID相比，没有ASA的Celecoxib与GI住院的可能性较小[危险比（HR）0.41，95％置信区间（CI）0.33-0.50];与NS-NSAID和ASA相比，塞来昔布和ASA与胃肠道住院的可能性也较小（HR 0.62，95％CI 0.48-0.80）;塞来昔布，ASA和不使用ASA的NS-NSAID的胃肠道住院率相似（HR 1.01，95％CI 0.81-1.25）。结论：在接受ASA心血管保护和抗炎药控制疼痛的老年患者中，塞来昔布在胃肠道毒性方面可能比NS-NSAIDs安全。

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