医学
相对风险
阿司匹林
药方
上消化道出血
人口
皮质类固醇
胃肠道出血
置信区间
队列研究
混淆
内科学
队列
绝对风险降低
低风险
回顾性队列研究
入射(几何)
前瞻性队列研究
优势比
危险系数
胃肠病学
急诊医学
儿科
环境卫生
内窥镜检查
药理学
作者
Gunnar Lauge Nielsen,Henrik Toft Sørensen,Lene Mellemkjoer,William J. Blot,Joseph K. McLaughlin,Ulrik Tage-Jensen,Jørgen H. Olsen
标识
DOI:10.1016/s0002-9343(01)00941-x
摘要
We assessed the risk of hospitalization for upper gastrointestinal bleeding among patients using systemic corticosteroids, accounting for the use of other drugs that may increase the risk of bleeding.We conducted a population-based cohort study in North Jutland County, Denmark. Data on the use of corticosteroids, nonsteroidal anti-inflammatory drugs, aspirin, and anticoagulants during 1991 to 1995 were obtained from a countywide prescription database. All hospitalizations because of upper gastrointestinal bleeding were identified through the Hospital Discharge Registry. The observed numbers of patients with gastrointestinal bleeding in various exposure categories among corticosteroid users were compared with the expected number based on the North Jutland population who did not receive prescriptions for any of the drugs under study.A total of 45,980 patients accrued 18,379 person-years of corticosteroid use. There were 109 hospital admissions for gastrointestinal bleeding among corticosteroid users, compared with 26 expected, yielding a relative risk of 4.2 [95% confidence interval (CI): 3.4 to 5.0]. Among corticosteroid users who did not use other drugs associated with gastrointestinal bleeding, the relative risk was 2.9 (95% CI: 2.2 to 3.7). The relative risk decreased further to 1.9 (95% CI: 1.4 to 2.5) when current corticosteroid usage was compared with former usage.We observed an increased risk of hospitalization because of upper gastrointestinal bleeding among patients prescribed corticosteroids, especially among those who use other medications. Confounding from the underlying disease may also have contributed to the observed increase in risk.
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