Lanas Angel, Perez-Aisa Maria Angeles, Feu Faust, Ponce Julio, Saperas Esteban, Santolaria Santos, Rodrigo Luis, Balanzo Joaquim, Bajador Eduardo, Almela Pedro, Navarro Jose M, Carballo Fernando, Castro Manuel, Quintero Enrique
Servicio de Aparato Digestivo, Hospital Clínico Zaragoza, Zaragoza, Spain.
Am J Gastroenterol. 2005 Aug;100(8):1685-93. doi: 10.1111/j.1572-0241.2005.41833.x.
The worst outcome of gastrointestinal complications is death. Data regarding those associated with nonsteroidal antiinflammatory drug (NSAID) or aspirin use are scarce.
To determine mortality associated with hospital admission due to major gastrointestinal (GI) events and NSAID/aspirin use.
The study was based on actual count of deaths from two different data sets from 2001. Study 1 was carried out in 26 general hospitals serving 7,901,198 people. Study 2 used a database from 197 general hospitals, representative of the 269 hospitals in the Spanish National Health System. Information regarding gastrointestinal complications and deaths was obtained throughout the Minimum Basic Data Set (CIE-9-MC) provided by participating hospitals. Deaths attributed to NSAID/aspirin use were estimated on the basis of prospectively collected data from hospitals of study 1.
The incidence of hospital admission due to major GI events of the entire (upper and lower) gastrointestinal tract was 121.9 events/100,000 persons/year, but those related to the upper GI tract were six times more frequent. Mortality rate was 5.57% (95% CI = 4.9-6.7), and 5.62% (95% CI = 4.8-6.8) in study 1 and study 2, respectively. Death rate attributed to NSAID/aspirin use was between 21.0 and 24.8 cases/million people, respectively, or 15.3 deaths/100,000 NSAID/aspirin users. Up to one-third of all NSAID/aspirin deaths can be attributed to low-dose aspirin use.
Mortality rates associated with either major upper or lower GI events are similar but upper GI events were more frequent. Deaths attributed to NSAID/ASA use were high but previous reports may have provided an overestimate and one-third of them can be due to low-dose aspirin use.
胃肠道并发症最严重的后果是死亡。关于非甾体抗炎药（NSAID）或阿司匹林使用相关并发症的数据很少。
确定因严重胃肠道（GI）事件住院及使用NSAID/阿司匹林所致的死亡率。
本研究基于2001年两个不同数据集的实际死亡人数。研究1在26家综合医院开展，服务人口为7,901,198人。研究2使用了来自197家综合医院的数据库，这些医院代表了西班牙国家卫生系统中的269家医院。通过参与医院提供的最低基本数据集（CIE - 9 - MC）获取胃肠道并发症和死亡信息。基于研究1医院前瞻性收集的数据估算NSAID/阿司匹林使用导致的死亡人数。
整个（上、下）胃肠道因严重GI事件住院的发生率为121.9例/100,000人/年，但上消化道相关事件的发生率高出6倍。研究1和研究2的死亡率分别为5.57%（95%CI = 4.9 - 6.7）和5.62%（95%CI = 4.8 - 6.8）。NSAID/阿司匹林使用导致的死亡率分别为21.0至24.8例/百万人口，即每100,000名NSAID/阿司匹林使用者中有15.3例死亡。所有NSAID/阿司匹林导致的死亡中，高达三分之一可归因于低剂量阿司匹林的使用。
与严重上消化道或下消化道事件相关的死亡率相似，但上消化道事件更常见。NSAID/ASA使用导致的死亡人数较高，但既往报告可能高估了这一数字，其中三分之一可能归因于低剂量阿司匹林的使用。
