PMID- 14632273
OWN - NLM
STAT- MEDLINE
DCOM- 20040312
LR  - 20221207
IS  - 1049-510X (Print)
IS  - 1049-510X (Linking)
VI  - 13
IP  - 4
DP  - 2003 Fall
TI  - Upper gastrointestinal toxicity of nonsteroidal anti-inflammatory drugs in 
      African-American and Hispanic elderly patients.
PG  - 528-33
AB  - OBJECTIVES: To determine the upper gastrointestinal (UGI) toxicity of 
      nonsteroidal anti-inflammatory drugs (NSAIDs), in African-American and Hispanic 
      elderly patients. SETTING: Inner-city community hospital. METHODS: Retrospective 
      review of records of 698 patients, 65 to 101 years old. Upper gastrointestinal 
      (UGI) symptoms and history of NSAIDs consumption were recorded over a 12-year 
      period. Twenty White and 25 Asian patients were excluded. Another 101 patients 
      were excluded because of incomplete data or because endoscopy was not performed. 
      Patients were stratified as NSAID-users or non-users, and the data were analyzed. 
      RESULTS: Among the 552 patients, the most common lesion was gastro-duodenal 
      erosions (34%), while common symptoms were abdominal pain (71%) and bleeding 
      (54%). Both lesions and symptoms were higher among NSAID-users than non-users 
      (P<.05). Endoscopic therapy was given to 296 patients, and was successful in 
      stopping the bleeding and/or delaying surgery in 70% of the patients. 
      Helicobacter pylori tests were done in 238 patients, and were positive in 47% of 
      the patients. Overall 144 deaths occurred (26%). Mortality was significantly 
      higher among elderly patients who used NSAIDs compared to those who did not use 
      them (P<.05). CONCLUSIONS: Our study suggests a higher association between NSAID 
      use and UGI toxicity than is reported in current literature. Patients suffering 
      from UGI toxicity of NSAIDs may remain asymptomatic until complications occur, 
      therefore a high index of suspicion and a low threshold for endoscopy are 
      essential, especially in elderly patients. Avoiding NSAIDs whenever possible, 
      substituting less toxic COX-2 inhibitors, monitoring risk, and providing 
      cotherapy with proton pump inhibitors (PPI), or misoprostol, as suggested in the 
      literature, may decrease NSAIDs associated morbidity and mortality in this 
      patient population.
FAU - Akhtar, Abbasi J
AU  - Akhtar AJ
AD  - Division of Gastroenterology, Department of Internal Medicine, Charles R. Drew 
      University of Medicine and Science, Los Angeles, California, USA.
FAU - Shaheen, Magda
AU  - Shaheen M
LA  - eng
GR  - G12-RR03026/RR/NCRR NIH HHS/United States
GR  - P20MD00182/MD/NIMHD NIH HHS/United States
PT  - Journal Article
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - Ethn Dis
JT  - Ethnicity & disease
JID - 9109034
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Anti-Inflammatory Agents, Non-Steroidal/*adverse effects
MH  - *Black People
MH  - Female
MH  - Gastrointestinal Diseases/*chemically induced/ethnology/mortality
MH  - Gastrointestinal Hemorrhage/etiology
MH  - *Hispanic or Latino
MH  - Humans
MH  - Male
MH  - Odds Ratio
MH  - Retrospective Studies
MH  - Urban Population
EDAT- 2003/11/25 05:00
MHDA- 2004/03/16 05:00
CRDT- 2003/11/25 05:00
PHST- 2003/11/25 05:00 [pubmed]
PHST- 2004/03/16 05:00 [medline]
PHST- 2003/11/25 05:00 [entrez]
PST - ppublish
SO  - Ethn Dis. 2003 Fall;13(4):528-33.