The use of
acetylsalicylic acid and other non-steroidal, anti-inflammatory drugs was studied prospectively in 207 patients admitted for suspected upper gastrointestinal
bleeding. In addition to detailed
drug history, plasma samples for
drug analyses were obtained from the majority of the patients. 64 of the patients admitted recent intake of ulcerogenic drugs, and the plasma samples revealed another 11 users.
Acetylsalicylic acid was the most prevalent substance, but all available non-steroidal, anti-inflammatory drugs were represented in the material.
Gastroduodenal ulcers were found in 94 (44%) of the patients; two thirds of the users and one third of the non-users.
Gastric ulcer was slightly more prevalent than
duodenal ulcer in both groups. Six patients with
drug-associated
bleeding had previously had a verified
drug-associated
ulcer. Only 12 users and 16 non-users denied dyspeptic complaints before admission. The users were older, they generally had a lower Hgb on admission than non-users had, and a slightly higher transfusion requirement, but these factors did not result in significant differences as to clinical outcome. The
drug analyses of plasma samples showed a discrepancy to the anamnestic data in 25% of the patients and may be a useful addition to
drug history in these studies.