Despite the high background rate of GI events, most NSAIDs increased the risk of GI hospitalization.
The team assessed the effect of specific nonsteroidal anti-inflammatory drugs (NSAIDs) on the rate of gastrointestinal (GI) hospitalizations, among older people living in long-term care.
They reported their findings in the May issue of the Journal of the American Geriatrics Society.
The researchers identified 125,516 newly admitted residents from a database of all residents (1992-1996) of every Medicare/Medicaid certified nursing homes in four US states.
Patients who received at least one prescription for aspirin (n = 19,101) or NSAIDs (n =
9,777) were identified.
The control population consisted of all institutionalized persons who did not receive these drugs.
|Diflunisal and oxaprozin increase GI hospitalization 6-fold.|
|Journal of the American Geriatrics Society|
From Health Care Financing Administration inpatient claims, they also identified the first hospitalization for GI perforation, ulcer, or hemorrhage that occurred during the year of follow-up.
Adjusted estimates of rate ratios were calculated.
NSAID exposure was found to increase the GI-event-related hospitalization rate in both men (rate ratios (RR) = 2.64) and women (RR = 3.23).
The rate of GI hospitalizations for both men and women taking sulindac, naproxen, or indomethacin was higher than for non-users.
The risk of GI-event-related hospitalizations was greatest among women exposed to diflunisal (RR = 6.08) or oxaprozin (RR = 6.03).
Dr Kate L. Lapane, of Brown University, Providence, Rhode Island, said on behalf of her colleagues "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," she concluded.