SynthesisBMC gastroenterology2009
Mortality with upper gastrointestinal bleeding and perforation: effects of time and NSAID use.
Synthesis in BMC gastroenterology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
54 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Mortality among patients due to adverse drug reactions that occur following hospitalisation: a meta-analysis.European journal of clinical pharmacology · 2019Pooled it
- Prophylactic use of aspirin: systematic review of harms and approaches to mitigation in the general population.European journal of epidemiology · 2015Pooled it
- Nonsteroidal anti-inflammatory drugs, gastroprotection, and benefit-risk.Pain practice : the official journal of World Institute of Pain · 2014Pooled it
- Effects of proton pump inhibitors on adverse gastrointestinal events in patients receiving clopidogrel: systematic review and meta-analysis.Drug safety · 2011Pooled it
- The Association between Absence of Abdominal Pain and Mortality in Lower Intestinal Perforation in Patients with Autoimmune Rheumatic Diseases.BioMed research international · 2019Trial
- Evaluation of the nonsteroidal anti-inflammatory drug-sparing effect of etanercept in axial spondyloarthritis: results of the multicenter, randomized, double-blind, placebo-controlled SPARSE study.Arthritis research & therapy · 2014Trial
- Trial
- A-Lines below the Diaphragm - A Case Report of Occult Pneumoperitoneum.Journal of education & teaching in emergency medicine · 2026Article
- Pharmacological evaluation of Adenostemma lavenia acetone extract in Swiss Albino mice: Analgesic, anti-inflammatory, and thrombolytic insights from in vivo, in vitro, density functional theory, and molecular docking studies.Animal models and experimental medicine · 2026Article
- NSAID Use, Gastrointestinal Complications, and Burden of Disease in Osteoarthritis: Nordic Registry Study with Emphasis on Patients Below 60 Years.Rheumatology and therapy · 2026Article
- Rebamipide as an Adjunctive Therapy for Gastrointestinal Diseases: An Umbrella Review.Pharmaceuticals (Basel, Switzerland) · 2026Review
- Administration of Metoclopramide Prior to Endoscopy for Acute Upper Gastrointestinal Bleeding: A Systematic Review and GRADE Meta-Analysis of Randomized Controlled Trials.JGH open : an open access journal of gastroenterology and hepatology · 2025Review
- Self-medication with NSAIDs and purchase of branded and over-the-counter medicines: Analysis of a national survey in Peru.Journal of public health research · 2025Article
- Life Expectancy of Patients Undergoing Total Knee Arthroplasty: Comparison With General Population.Journal of Korean medical science · 2024Article
- Trends for Admission, Mortality and Emergency Surgery in Upper Gastrointestinal Bleeding: A Study of Eight Years of Admissions in a Tertiary Care Hospital.International journal of general medicine · 2024Article
- Efficacy and NSAID-sparing effect of secukinumab 150 mg in ankylosing spondylitis: results from phase IV ASTRUM study.Therapeutic advances in musculoskeletal disease · 2024Article
- The global epidemiology of upper and lower gastrointestinal bleeding in general population: A systematic review.World journal of gastrointestinal surgery · 2023Article
- Article
- Keratinocyte Carcinoma and Photoprevention: The Protective Actions of Repurposed Pharmaceuticals, Phytochemicals and Vitamins.Cancers · 2021Review
- Open-Label Placebo Treatment for Acute Postoperative Pain (OLP-POP Study): Study Protocol of a Randomized Controlled Trial.Frontiers in medicine · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSome people who suffer an upper gastrointestinal bleed or perforation die. The mortality rate was estimated at 12% in studies published before 1997, but a systematic survey of more recent data is needed. Better treatment is likely to have reduced mortality. An estimate of mortality is helpful in explaining to patients the risks of therapy, especially with NSAIDs.
methodsA systematic review of studies published before 1997, and between 1997 and 2008. Any study architecture was acceptable if it reported on cases who died from any cause of upper gastrointestinal bleed or perforation. Analyses were conducted separately for all cases, and those prescribed NSAID or aspirin.
resultsInformation was available for 61,067 cases (81% published since 1997) of whom 5,001 died. The mortality rate in all cases fell significantly, from 11.6% (95% confidence interval, 11.0 to 12.2) in pre-1997 studies to 7.4% (7.2 to 7.6) in those published since 1997. In 5,526 patients taking NSAID or aspirin, mortality increased, from 14.7% (13.6 to 15.8) before 1997 to 20.9% (18.8 to 22.9) since 1997.
conclusionUpper gastrointestinal bleed or perforation still carries a finite risk of death. Differences in study architecture, population characteristics, risk factors, definition of mortality, and reporting of outcomes impose limitations on interpreting effect size. Data published since 1997 suggest that mortality in patients suffering from an upper gastrointestinal bleed or perforation has fallen to 1 in 13 overall, but remains higher at about 1 in 5 in those exposed to NSAID or aspirin.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.