The impact of selective serotonin receptor inhibitors on post-endoscopic sphincterotomy bleeding, alone or with concurrent aspirin or nonsteroidal anti-inflammatory drugs
| Autor: | Panagiotis Katsinelos, Sotiris Terzoudis, Apostolis Papaefthymiou, Sotiris Anastasiadis, Michael Doulberis, Taxiarchis Katsinelos, Georgia Lazaraki, Jannis Kountouras, Grigoris Chatzimavroudis, Anthi Gatopoulou |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
aspirin Gastroenterology 03 medical and health sciences 0302 clinical medicine Internal medicine mental disorders medicine 030212 general & internal medicine Endoscopic sphincterotomy Risk factor Aspirin nonsteroidal anti-inflammatory drugs Endoscopic retrograde cholangiopancreatography medicine.diagnostic_test business.industry Incidence (epidemiology) digestive oral and skin physiology Odds ratio medicine.disease bleeding Confidence interval selective serotonin receptor inhibitors 030211 gastroenterology & hepatology Observational study Original Article Upper gastrointestinal bleeding business medicine.drug |
| Zdroj: | Annals of Gastroenterology |
| ISSN: | 1108-7471 |
| Popis: | Background Observational studies have shown an increased risk of upper gastrointestinal bleeding in users of selective serotonin receptor inhibitors (SSRIs). We retrospectively investigated the impact of SSRIs, alone or combined with aspirin (ASA) or nonsteroidal anti-inflammatory drugs (NSAIDs), on the incidence of post-endoscopic sphincterotomy (post-ES) bleeding. Methods A total of 3058 patients were included. Of these, 457 patients received SSRIs, alone or plus ASA or NSAIDs, until the day of ES (SSRIs group), while 2659 patients (non SSRIs group) had never been on SSRIs (n=1925), though some had been on ASA (n=613) or NSAIDS (n=121). Patient assessment included indication for endoscopic retrograde cholangiopancreatography (ERCP), comorbid diseases, detailed drug history before and after ES, procedural details, and risk factors for post-ES bleeding. Primary outcome was defined as the incidence, type and severity of post-ES bleeding. Results There was no statistical difference in age, sex, indication for ERCP, comorbid diseases, technical characteristics or results of therapeutic ERCP between the 2 groups. The incidence of post-ES bleeding was 3.9% in the SSRIs group and 3% in the non SSRIs group, a difference not statistically significant (P=0.754). Likewise, there was no difference in type (P=0.145) or severity of bleeding (P=0.754) between the 2 groups. Multivariate analysis showed the precut technique as the only independent risk factor for post ES hemorrhage (odds ratio 2.56, 95% confidence interval 1.23-3.63; P=0.001). Conclusion This study found that SSRIs, alone or combined with ASA or NSAIDs, had no influence on the incidence or the severity of post-ES bleeding. |
| Databáze: | OpenAIRE |
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