NSAIDs increase risk of gastrointestinal bleeding in primary care patients with dyspepsia

J Fam Pract. 1997 Sep;45(3):227-35.


Background: A 1-year prospective study of 545 patients with dyspepsia examined the natural history of dyspepsia in a primary care population. Predictors of gastrointestinal bleeding and other related utilization-of-service indicators were identified.

Methods: Subjects were adult primary care patients seen at a southern California county medical center. Data were collected by means of a patient questionnaire as well as from medical charts and a computerized hospital billing system. Chi-square, t test, and stepwise multiple logistic regression analyses were used to analyze the data. Outcome events were follow-up visits for any gastrointestinal event and follow-up visits for gastrointestinal bleeding specifically.

Results: Prior exposure to nonsteroidal anti-inflammatory drugs doubled the odds for any follow-up gastrointestinal event (odds ratio = 1.9; 95% CI = 1.4 to 2.8). Nonsteroidal anti-inflammatory drugs increased the risk for gastrointestinal bleeding by a factor of 7 (odds ratio = 7.1; 95% CI = 1.3 to 50.0).

Conclusions: In a cohort of primary care patients with dyspepsia, use of nonsteroidal anti-inflammatory drugs was the most important predictor of a follow-up gastrointestinal event, both for any gastrointestinal event and gastrointestinal bleeding specifically.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Alcohol Drinking
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Arthritis / drug therapy
  • Dyspepsia / complications*
  • Family Practice
  • Female
  • Gastrointestinal Diseases / etiology
  • Gastrointestinal Diseases / prevention & control
  • Gastrointestinal Hemorrhage / chemically induced*
  • Gastrointestinal Hemorrhage / etiology
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk Factors


  • Anti-Inflammatory Agents, Non-Steroidal