ArticleJournal of gastroenterology2014
Primary non-variceal upper gastrointestinal bleeding in NSAID and low-dose aspirin users: development and validation of risk scores for either medication in two large Dutch cohorts.
Article in Journal of gastroenterology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- Risk factors for anticoagulant-associated gastrointestinal hemorrhage: a systematic review and meta-analysis.The Korean journal of internal medicine · 2024Pooled it
- Pooled it
- The integration of spear and shield: a panoramic analysis of the blood circulation-promoting and hemostatic effects of Panax notoginseng.Chinese medicine · 2025Review
- LASSO-derived model for the prediction of bleeding in aspirin users.Scientific reports · 2024Article
- Incidence and outcomes of high bleeding risk patients with type 1 and type 2 myocardial infarction in a community-based cohort: Application of the Academic Research Consortium High Bleeding Risk Criteria.International journal of cardiology · 2024Article
- Clinical Outcomes of Older Patients with Non-Variceal Upper Gastrointestinal Bleeding Taking Anti-Thrombotic or Non-Steroidal Anti-Inflammatory Agents.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2023Article
- Personalized Approaches to Antiplatelet Treatment for Cardiovascular Diseases: An Umbrella Review.Pharmacogenomics and personalized medicine · 2023Review
- Article
- Comparison of clinical performance of four gastrointestinal bleeding risk scores in Chinese patients with atrial fibrillation receiving oral anticoagulants.Journal of thrombosis and thrombolysis · 2021Article
- Refining prediction of major bleeding on antiplatelet treatment after transient ischaemic attack or ischaemic stroke.European stroke journal · 2020Article
- Daily Usage of Proton Pump Inhibitors May Reduce the Severity of Critical Upper Gastrointestinal Bleeding in Elderly Patients.Gastroenterology research and practice · 2020Article
- Defining high bleeding risk in patients undergoing percutaneous coronary intervention: a consensus document from the Academic Research Consortium for High Bleeding Risk.European heart journal · 2019Article
- Defining High Bleeding Risk in Patients Undergoing Percutaneous Coronary Intervention.Circulation · 2019Review
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNon-steroidal anti-inflammatory drugs (NSAIDs) and low-dose acetylsalicylic acid (ASA) have several adverse gastrointestinal (GI) effects, including upper GI bleeding. We aimed to develop a simple risk score to identify high risk NSAID and ASA users for primary upper GI bleeding.
methodsUsing data from two large anonymized health insurance databases, we defined a development and validation cohort with NSAID and ASA users which were followed-up for the occurrence of a primary upper GI bleeding. Cox regression analyses identified risk factors which were combined into simple risk scores. C-statistics were used to evaluate the discriminative ability of these scores in a validation cohort.
resultsIn total, 421 cases of upper GI bleeding were identified in the initial cohort of 784,263 NSAID users (incidence rate 54.2 per 10,000 person-years), while 1,295 cases of upper GI bleeding were identified in 235,531 ASA users (incidence rate 37.9 per 10,000 person-years). The risk of upper GI bleeding increased with a higher risk score, which for NSAID users included age, male gender, anemia and concomitant use of ASA or anticoagulants. For ASA users, age, anemia, diabetes and concomitant use of other antiplatelet drugs or anticoagulants were included in the risk score. The C-statistics in the validation cohort were 0.68 and 0.63 or NSAID and ASA users, respectively.
conclusionRisk factors for primary upper GI bleeding are to a large extent similar for NSAID and ASA users. Using a risk score based on these risk factors, patients at the highest risk can be identified with moderate accuracy.
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