Gastrointestinal Risk Assessment in the Patients Taking Nonsteroidal Anti-inflammarory Drugs for Lumbar Spinal Disease

ABSTRACT

STUDY DESIGN: A cross-section observational study. OBJECTIVES: To evaluate the current prescription patterns of non-steroidal anti-inflammatory drugs (NSAIDs) and gastrointestinal (GI) risk assessment in patients with lumbar spine disease. SUMMARY OF LITERATURE REVIEW NSAIDs are commonly prescribed medications for lumbar spine disease patients. Since the rate of GI complication varies for each patient, identification of individual GI risks is a prerequisite to prevent such a complication. There are few reports about the GI risks in patients with lumbar spine disease who take NSAIDs. MATERIALS AND METHODS: 2264 patients with lumbar degenerative spondylopathy who were taking NSAIDs were enrolled from May 2010 to September 2010. The Standardized Calculator of Risk for Event (SCORE) was used to measure patients' GI risk factors. NSAID prescription patterns and GI protective agents were also investigated. RESULTS: Being aged over 65 (1098 patients; 48.5%) and the presence of GI side-effects from NSAIDs (896 patients; 39.6%) were the most common risk factors. 31.9% and 5.8% percent of patients belonged to each of the high risk and the very high risk groups in GI risk factor analysis. The total prescription rate of gastroprotectants was 91.7% for all patients. However, the prescription rate of selective COX-2 inhibitors in the high risk group was low, and in 54.8% of patients who took COX-2 inhibitors there was GI discomfort. CONCLUSIONS: The prescription pattern of GI protective agents was not correlated with GI symptoms. Therefore, physicians should consider NSAID prescription based on the GI risk factors of individual patients.