Abstract
Background : Recently, aspirin has been used to prevent cerebro-cardiovascular disease because of its antiplatelet effect in elderly patients, and NSAIDs are widely used for their anti-inflammatory effects. However, use of these drugs incurs the risk of severe gastroduodenal bleeding ulcers. Endoscopic hemostasis has been introduced as a safe and effective approach to treat bleeding ulcers. The aim of this retrospective cohort study was to investigate the efficacy of hemostasis as an initial treatment in patients with aspirin, NSAIDs and peptic types of ulcers.
Patients and methods : At Showa University Hospital, 188 patients received emergency endoscopic hemostasis of bleeding gastroduodenal ulcers. Criteria for assessment of completeness of hemostasis was defined as the absence of either coagulated or fresh blood.
Results : Patients were classified into three groups as follows: aspirin ulcers (43 patients) , NSAIDs (without use of aspirin) ulcers (31 patients) , and conventional peptic (without use of NSAIDs) ulcers (114 patients) . Re-bleeding rate was 14.0% (6 of 43patients) , 6.5% (2 of 31) and 11.4% (13 of 114) , re-spectively. There were no statistically significant differences between the three groups.
Conclusions : In this study, there was no difference for re-bleeding rates between patients with aspirin, NSAIDs or peptic ulcers. Aspirin and NSAIDs should therefore not necessarily be considered risk factors for re-bleeding gastroduodenal ulcers after endoscopic hemostasis.
