The Experts below are selected from a list of 15 Experts worldwide ranked by ideXlab platform
Renato Fellin - One of the best experts on this subject based on the ideXlab platform.
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Risk of hospitalization for upper gastrointestinal tract Bleeding.
Journal of clinical epidemiology, 2004Co-Authors: Massimo Gallerani, Michele Simonato, Roberto Manfredini, Stefano Volpato, Giovanni Battista Vigna, Renato FellinAbstract:Abstract Objective This study evaluates the hospitalization risk for upper gastrointestial Bleeding (UGIB) with reference to the clinical characteristics of patients and drugs taken before admission. Methods This study is based on the GIFA (Italian Group for the Pharmacosurveillance in the Elderly) database. Cases with an ICD-9 code of esophagus, stomach or Duodenum Bleeding, or acute esophago-gastroduodenal disease associated with anemia have been classified as UGIB. Sex, age, year of observation, drugs taken at home, comorbidity, smoking, alcohol, and use of gastroprotectants have been also taken into account. Statistical analysis has been conducted using multivariate logistic regression models. Results 32,388 patients have been enrolled, 940 of which presented UGIB. Age, comorbidity, use of smoke and alcohol, hospitalization duration, and mortality during hospitalization were significantly higher in UGIB than nonUGIB patients. Increased UGIB risk has been found in patients taking NSAIDs (both when aspirin was included or excluded), acetaminophen, constipating agents, iron, ethacrynic acid, propranolol. Reduced UGIB risk has been found in patients taking nitrates. Conclusions UGIB risk appears to correlate with clinical characteristics of the patient: it increases with age, comorbidity, and smoke and alcohol consumption. Among drugs, NSAIDs are associated with the highest UGIB risk, while nitrates with a reduction of risk.
L Bisanti - One of the best experts on this subject based on the ideXlab platform.
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Spironolactone and gastrointestinal Bleeding: A population based study
Pharmacoepidemiology and Drug Safety, 2008Co-Authors: A. Russo, M Autelitano, L BisantiAbstract:Background: Several medical reports showed an increased risk of stomach and Duodenum Bleeding associated with the use of spironolactone. The objective of this work is to examine the association between upper gastrointestinal (UGI) Bleeding and exposure to spironolactone, using a population-based cohort design. Methods: Using the pharmaceutical prescriptions from 2000 to 2006, a cohort was identified of residents in Milan (Italy) with chronic exposure to spironolactope or other diuretic drugs. The main outcome was defined as the hospital admission for UGI Bleeding or ulcers. To control for potential bias related to spironolactone use, the propensity score was estimated. Then, each patient treated with spironolactone was randomly matched with one treated with other diuretics and having the same propensity score using the caliper matching method. Proportional hazard models were fitted by computing hazard ratios (HR) and the corresponding 95% confidence intervals (95%CI). Results: A total of 53 550 unexposed and 10 564 exposed to spironolactone were identified. Overall in the study period, 174 patients (3.2%) developed UGI Bleeding in the unexposed and 51 (4.8%) in the exposed group. HR for UGI Bleeding for the spironolactone exposed group was 1.94 (95%CI 1.42-2.65). The sensitivity analysis based on the matched design using the propensity score showed a statistically significant twofold increase of gastrointestinal Bleeding only among subjects exposed to high spironolactone dose (HR 2.50; 95%CI 1.08-5.79). Conclusions: Results from a large population based study confirm that spironolactone increases the risk of UGI Bleeding. Copyright © 2008 John Wiley & Sons, Ltd.
Massimo Gallerani - One of the best experts on this subject based on the ideXlab platform.
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Risk of hospitalization for upper gastrointestinal tract Bleeding.
Journal of clinical epidemiology, 2004Co-Authors: Massimo Gallerani, Michele Simonato, Roberto Manfredini, Stefano Volpato, Giovanni Battista Vigna, Renato FellinAbstract:Abstract Objective This study evaluates the hospitalization risk for upper gastrointestial Bleeding (UGIB) with reference to the clinical characteristics of patients and drugs taken before admission. Methods This study is based on the GIFA (Italian Group for the Pharmacosurveillance in the Elderly) database. Cases with an ICD-9 code of esophagus, stomach or Duodenum Bleeding, or acute esophago-gastroduodenal disease associated with anemia have been classified as UGIB. Sex, age, year of observation, drugs taken at home, comorbidity, smoking, alcohol, and use of gastroprotectants have been also taken into account. Statistical analysis has been conducted using multivariate logistic regression models. Results 32,388 patients have been enrolled, 940 of which presented UGIB. Age, comorbidity, use of smoke and alcohol, hospitalization duration, and mortality during hospitalization were significantly higher in UGIB than nonUGIB patients. Increased UGIB risk has been found in patients taking NSAIDs (both when aspirin was included or excluded), acetaminophen, constipating agents, iron, ethacrynic acid, propranolol. Reduced UGIB risk has been found in patients taking nitrates. Conclusions UGIB risk appears to correlate with clinical characteristics of the patient: it increases with age, comorbidity, and smoke and alcohol consumption. Among drugs, NSAIDs are associated with the highest UGIB risk, while nitrates with a reduction of risk.
A. Russo - One of the best experts on this subject based on the ideXlab platform.
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Spironolactone and gastrointestinal Bleeding: A population based study
Pharmacoepidemiology and Drug Safety, 2008Co-Authors: A. Russo, M Autelitano, L BisantiAbstract:Background: Several medical reports showed an increased risk of stomach and Duodenum Bleeding associated with the use of spironolactone. The objective of this work is to examine the association between upper gastrointestinal (UGI) Bleeding and exposure to spironolactone, using a population-based cohort design. Methods: Using the pharmaceutical prescriptions from 2000 to 2006, a cohort was identified of residents in Milan (Italy) with chronic exposure to spironolactope or other diuretic drugs. The main outcome was defined as the hospital admission for UGI Bleeding or ulcers. To control for potential bias related to spironolactone use, the propensity score was estimated. Then, each patient treated with spironolactone was randomly matched with one treated with other diuretics and having the same propensity score using the caliper matching method. Proportional hazard models were fitted by computing hazard ratios (HR) and the corresponding 95% confidence intervals (95%CI). Results: A total of 53 550 unexposed and 10 564 exposed to spironolactone were identified. Overall in the study period, 174 patients (3.2%) developed UGI Bleeding in the unexposed and 51 (4.8%) in the exposed group. HR for UGI Bleeding for the spironolactone exposed group was 1.94 (95%CI 1.42-2.65). The sensitivity analysis based on the matched design using the propensity score showed a statistically significant twofold increase of gastrointestinal Bleeding only among subjects exposed to high spironolactone dose (HR 2.50; 95%CI 1.08-5.79). Conclusions: Results from a large population based study confirm that spironolactone increases the risk of UGI Bleeding. Copyright © 2008 John Wiley & Sons, Ltd.
Giovanni Battista Vigna - One of the best experts on this subject based on the ideXlab platform.
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Risk of hospitalization for upper gastrointestinal tract Bleeding.
Journal of clinical epidemiology, 2004Co-Authors: Massimo Gallerani, Michele Simonato, Roberto Manfredini, Stefano Volpato, Giovanni Battista Vigna, Renato FellinAbstract:Abstract Objective This study evaluates the hospitalization risk for upper gastrointestial Bleeding (UGIB) with reference to the clinical characteristics of patients and drugs taken before admission. Methods This study is based on the GIFA (Italian Group for the Pharmacosurveillance in the Elderly) database. Cases with an ICD-9 code of esophagus, stomach or Duodenum Bleeding, or acute esophago-gastroduodenal disease associated with anemia have been classified as UGIB. Sex, age, year of observation, drugs taken at home, comorbidity, smoking, alcohol, and use of gastroprotectants have been also taken into account. Statistical analysis has been conducted using multivariate logistic regression models. Results 32,388 patients have been enrolled, 940 of which presented UGIB. Age, comorbidity, use of smoke and alcohol, hospitalization duration, and mortality during hospitalization were significantly higher in UGIB than nonUGIB patients. Increased UGIB risk has been found in patients taking NSAIDs (both when aspirin was included or excluded), acetaminophen, constipating agents, iron, ethacrynic acid, propranolol. Reduced UGIB risk has been found in patients taking nitrates. Conclusions UGIB risk appears to correlate with clinical characteristics of the patient: it increases with age, comorbidity, and smoke and alcohol consumption. Among drugs, NSAIDs are associated with the highest UGIB risk, while nitrates with a reduction of risk.
