Aspirin Use in Patients with Major Upper Gastrointestinal Bleeding and Peptic-Ulcer Disease

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Abstract
Possible relations between long-term regular use of aspirin-containing drugs and hospital admissions for (1) major upper gastrointestinal bleeding in the absence of known predisposing conditions and (2) newly diagnosed peptic ulcer were explored in a large hospital survey. For patients who were admitted with major bleeding and in whom there was no evidence of duodenal ulcer, there was a statistically significant association with aspirin taken regularly for four or more days a week (p<0.01). A similar association was found for patients admitted with newly diagnosed and uncomplicated benign gastric ulcer (p<0.05). The corresponding estimated incidence rates of hospital admissions, for these two conditions, that were attributable to this level of aspirin use were 15 and 10 per 100,000 users per year, respectively. Aspirin taken regularly for four or more days a week was not significantly associated with either bleeding or uncomplicated duodenal ulcer. There was no evidence of significant associations with the diseases under consideration when less heavy use of aspirin was considered. (N Engl J Med 290:1158–1162, 1974)