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Thromb Haemost 2001; 86(02): 563-568
DOI: 10.1055/s-0037-1616087
Review Article
Schattauer GmbH

Hospitalisation for Upper Gastrointestinal Bleeding Associated with Use of Oral Anticoagulants

Søren P. Johnsen
1   Department of Epidemiology and Social Medicine, University of Aarhus, Denmark
,
Henrik Toft Sørensen
2   Department of Clinical Epidemiology at Aarhus University Hospital and Aalborg Hospital, Denmark
,
Lene Mellemkjœr
3   Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
,
William J. Blot
4   International Epidemiology Institute, Rockville, MD, USA
5   Vanderbilt University Medical Center, Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
,
Gunnar Lauge Nielsen
2   Department of Clinical Epidemiology at Aarhus University Hospital and Aalborg Hospital, Denmark
6   Department of Medicine M, Aalborg Hospital, Aalborg, Denmark
,
Joseph K. McLaughlin
4   International Epidemiology Institute, Rockville, MD, USA
5   Vanderbilt University Medical Center, Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
,
Jørgen H. Olsen
3   Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
› Author Affiliations
Further Information

Publication History

Received 19 October 2000

Accepted after resubmission 27 February 2001

Publication Date:
12 December 2017 (online)

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Summary

The incidence of hospitalisation for upper GI bleeding with use of oral anticoagulants (OA) alone or in combination with other drugs was examined in a cohort of 4,204 users of OA, identified through record linkage between a population-based prescription database and a hospital discharge registry in Denmark, and compared with the incidence in the general population not exposed to OA. The standardised incidence ratio (SIR) was 2.8 (95% CI = 1.6-4.5) for use of OA alone. SIRs tended to be higher for use of OA combined with acetaminophen alone (4.4, 95% CI = 1.2-11.4), non-aspirin NSAIDs alone (8.0, 95% CI = 2.1 to 20.4) or aspirin/corticosteroids alone (3.8, 95% CI = 0.8-11.0), respectively.

These results indicate that use of OA is associated with a significantly increased risk of upper GI bleeding, with still higher risks associated with the concomitant use of other medications including acetaminophen. Further research is needed to clarify the extent to which drugs interacting with oral anticoagulants may cause GI bleeding and the mechanisms through which these associations operate.

Keywords

Epidemiology - oral anticoagulant - acetaminophen - gastrointestinal bleeding
 

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