A team from Denmark and the USA assessed the risk of hospitalization for upper gastrointestinal (GI) bleeding among patients using systemic corticosteroids.
The use of any other drugs that may increase the risk of bleeding was accounted for.
A population-based cohort study was conducted in North Jutland County, Denmark.
Data on the use of corticosteroids, nonsteroidal anti-inflammatory drugs, aspirin, and anticoagulants between 1991 to 1995 were obtained from a countywide prescription database.
All hospitalizations due to upper GI bleeding were identified through the Hospital Discharge Registry.
The observed numbers of patients with GI bleeding, in various exposure categories, among corticosteroid users were noted. These were compared with the expected number, based on the North Jutland population, who did not receive prescriptions for any of the drugs under study.
A total of 45,980 patients accrued 18,379 person-years of corticosteroid use.
| Hospital admissions risk for upper GI bleeding 4-times greater among corticosteroid users.
| American Journal of Medicine |
There were found to be 109 hospital admissions for GI bleeding among corticosteroid users, compared with 26 expected, yielding a relative risk of 4.2.
Among corticosteroid users who did not use other drugs associated with GI bleeding, the relative risk was 2.9.
The researchers found that the relative risk decreased further to 1.9 when current corticosteroid usage was compared with former usage.
Dr Gunnar L. Nielsen, of the Aalborg and Aarhus University Hospitals, Denmark, said on behalf of fellow colleagues, "We observed an increased risk of hospitalization because of upper GI bleeding among patients prescribed corticosteroids, especially among those who use other medications."
"Confounding from the underlying disease may also have contributed to the observed increase in risk," it was concluded.