Ulcer complications and nonsteroidal anti-inflammatory drugs.

摘要: Rates of ulcer perforation, hospital admission, and death are usually regarded as the best available measures frequency severe peptic disease. Overall admission rates have tended to decline, which almost certainly reflects widespread adoption effective outpatient therapy. The overall incidence perforation may also fallen. However, at least in Europe, United Kingdom particular, there be differences between young elderly; appear declining, whereas they rising or static elderly. Although various interpretations for these changing patterns, data suggest that during last 15 20 years some unidentified factor factors began influence disease among At part this change reflect increasingly frequent prescribing nonsteroidal anti-inflammatory drugs (NSAIDs). In Kingdom, most adverse drug reactions attributable NSAIDs gastrointestinal serious. Bleeding common, occur absence warning symptoms, associated with a high mortality rate. countries, other factors, including smoking diet, equally important. It is difficult determine relative contribution each factor, though perception tolerance poor, particularly elderly, well founded. About half prescriptions non-aspirin patients over 60 age. one quarter all cases upper bleeding elderly likely caused by rate 10 percent possibly higher. absolute risk serious complication low, perhaps several thousand NSAID prescriptions, total burden because multimillion issued yearly.