Hospitalisation and associated costs of gastrointestinal bleeding from primary prevention aspirin use in South Australia: a retrospective case series analysis

Abstract

We assessed hospitalisations for gastrointestinal bleeding directly related to primary prevention aspirin in lower risk patients for a 6-month period in three South Australian hospitals. Those with related underlying pathology or concurrent causative medication were excluded. Identified patients (n = 22) carried little co-morbidity, 41% received prior proton-pump inhibitors and 68% were aged >70 years.

Combined population genomic screening for three high-risk conditions in Australia: a modelling study

“… 42 Cost of hysterectomy AU$12,124 ±25% Gamma Lynch Syndrome Australia 19 Cost per gastrointestinal bleeding hospitalisation AU$60,769 ±25% Gamma Roberts et al. 57 Utility weight CRC 0.76 0.699–0.823 Beta Farlikka et al. 58 Utility weight post-CRC health state 0.85 ±16% (SD) Beta Mulder et al.…”

Prescribing aspirin to older people – where is the line between cardiovascular benefit and upper gastrointestinal bleeding risk?

“…In this journal, three recent independent studies from three states in Australia reported that most non-variceal UGIB episodes in those aged ≥70 years are attributable to low-dose aspirin use. [18][19][20] First, among people aged ≥70 years admitted with UGIB to a Western Australian tertiary hospital, those taking regular low-dose aspirin had a nine-fold increased risk of presentation with overt UGIB characterised by haematemesis and/or melaena compared with those not taking aspirin. 18 Three-quarters of older people with UGIB had been taking aspirin.…”

“…19 In the third study, Roberts et al found increased risk of UGIB associated with aspirin used for primary prophylaxis in adults with mean age 70 years in a three-hospital South Australian Study. 20 The mean cost of hospitalisation with UGIB was estimated as A$6769. Extrapolating this cost to the 25 727 people aged ≥70 years from the AIHW data provides an annual estimate of hospitalisation costs of over $AU170 million in older people with gastroduodenal ulcers.…”

“…It is assumed that the bulk of such prescribed aspirin is for older people, who are more likely to have established atherosclerotic cardiovascular disease (ASCVD) and be at high risk for gastroduodenal ulceration and bleeding. In this journal, three recent independent studies from three states in Australia reported that most non‐variceal UGIB episodes in those aged ≥70 years are attributable to low‐dose aspirin use 18–20 . First, among people aged ≥70 years admitted with UGIB to a Western Australian tertiary hospital, those taking regular low‐dose aspirin had a nine‐fold increased risk of presentation with overt UGIB characterised by haematemesis and/or melaena compared with those not taking aspirin 18 .…”

“…In the third study, Roberts et al . found increased risk of UGIB associated with aspirin used for primary prophylaxis in adults with mean age 70 years in a three‐hospital South Australian Study 20 . The mean cost of hospitalisation with UGIB was estimated as A$6769.…”