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NSAID Use May Up Risk of Death from Peptic Ulcer Perforation

Thirty-day mortality rate higher in patients who used traditional NSAIDs or COX-2 inhibitors

MONDAY, Jan. 1 (HealthDay News) -- In patients undergoing a first hospitalization for peptic ulcer perforation, current use of non-steroidal anti-inflammatory drugs (NSAIDs), including selective cyclo-oxygenase-2 (COX-2) inhibitors, is associated with an increased risk of death, researchers report in the December issue of the American Journal of Gastroenterology.

Reimar W. Thomsen, M.D., Ph.D., of the Aarhus University Hospital in Aalborg and Aarhus, Denmark, and colleagues studied 2,061 patients, 38 percent of whom were current NSAID users.

The researchers found that 30-day mortality was 25 percent overall, but 35 percent among current NSAID users. Compared to never-use, the adjusted 30-day mortality rate ratios were 1.8 for current use of NSAIDs alone and 1.6 for current use in combination with other ulcer-associated drugs. The mortality increase associated with the use of COX-2 inhibitors was similar to that of traditional NSAIDs with an adjusted mortality rate ratio for users of COX-2 inhibitors alone and in combination, 2.0 and 1.4, respectively.

"A number of mechanisms may explain the poor prognosis associated with NSAID use," the authors write.

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