Risk of hospitalization for upper gastrointestinal tract complications associated with non‐selective non‐steroidal anti‐inflammatory drugs in Malaysia: a retrospective case control study

Aims: To assess the association between non‐steroidal anti‐inflammatory drug (NSAID) use and upper gastrointestinal (GI) tract‐related hospitalizations and to evaluate inpatient healthcare resource utilization associated with these complications in Malaysia. Methods: A retrospective case control study was performed using medical records of patients admitted to two Malaysian hospitals during 1999 and 2000. Cases were identified based on mode of presentation at hospital admission. One control was identified for each case, matched by age, sex and admission date. NSAID exposure was determined by drug use during one year prior to admission. Conditional logistic regression analysis was used to determine the association between NSAID use and upper GI complications, adjusting for predictors. Results: The 273 cases were significantly more likely to have used NSAIDs in the year prior to hospitalization than controls (27.8%vs. 6.2% of patients; P < 0.0001). Conditional logistic regression analysis adjusting for other predictors showed that the odds of being hospitalized for upper GI tract complications were 4.1 times higher among NSAID users than non‐users (95% CI = 1.88–9.12). Other risk factors for GI‐related hospitalizations were a history of upper GI tract complications (OR = 5.8, 95% CI = 1.28–26.53), use of gastroprotective agents (OR = 5.3, 95% CI = 1.67–16.79), and use of antacids (OR = 5.0, 95% CI = 2.10–11.91) in the previous year. Conclusion: This study demonstrated that NSAID exposure was significantly higher among patients hospitalized for GI‐related complications than for other reasons, indicating that NSAID use is an independent risk factor for upper GI tract complications in this Malaysian sample.