Do aspirin and non-steroidal anti-inflammatory drugs increase the risk of post-sphincterotomy hemorrhage – A case-control study - 16/04/13
, Erkan Parlak a, Meral Akdogan a, Yusuf Yesil a, Sedef Ozdal Kuran a, Mevlut Kurt a, Selcuk Disibeyaz a, Eda Ozturk a, Bulent Odemis b
Corresponding author. Ceyhun Atuf Kansu Cad Ehl-i Beyt Mah 1268, Sok 10/6, TR-06520, Balgat, Çankaya, Ankara, Turkey. Tel.: +90 5065041834; fax: +90 312 3124120.Bienvenue sur EM-consulte, la référence des professionnels de santé.
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Summary |
Background and objective |
Non-steroidal anti-inflammatory drugs (NSAIDs) and aspirin have antiaggregant properties and patients with pancreaticobiliary disease commonly use these drugs. We prospectively investigated whether aspirin and NSAIDs are associated with endoscopic sphincterotomy related hemorrhage.
Methods |
Three hundred and eight patients who underwent sphincterotomy were sequentially recruited into this prospective case-control study. Pre-endoscopic assessment included a complete blood count, coagulation studies and a detailed drug history after sphincterotomy patients were followed up for bleeding. Cases and controls were compared for patient and procedure-related risk factors of post-endoscopic sphincterotomy bleeding.
Results |
Hemorrhage occured in 74 (24%) patients. Eight (2.6%) were clinically significant and five (1.6%) were severe. Amongst cases with hemorrhage, 17.6% were on NSAIDs and 14.9% on aspirin; 27.4% of controls took NSAIDs, and 9.8% aspirin (P>0.05). Aspirin use in patients with significant (12.5%) or severe hemorrhage (20%) was not different from the controls (P>0.05) and none of them had NSAIDs prior to sphincterotomy. Based on univariate analysis, coagulopathy and comorbidity were risk factors for significant post-sphincterotomy hemorrhage and coagulopathy was the only independent parameter (odds ratio=22.72, 95% CI [4.25; 125]).
Conclusion |
Aspirin and NSAIDs do not increase the risk of post-sphincterotomy hemorrhage and they can be safely used before the procedure.
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Vol 37 - N° 2
P. 171-176 - avril 2013 Retour au numéro
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