Published Online
on January 16, 2003

A more recent version of this article appeared on February 1, 2003

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Submitted on August 29, 2002
Accepted on September 12, 2002

Nonaspirin Nonsteroidal Anti-Inflammatory Drugs and Risk of Hospitalization for Intracerebral Hemorrhage. A Population-Based Case-Control Study

Søren P. Johnsen MD^*; Lars Pedersen MSc; Søren Friis MD; William J. Blot PhD; Joseph K. McLaughlin PhD; Jørgen H. Olsen DMSc; and Henrik T. Sørensen DMSc

From the Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, and Aalborg Hospital, Aalborg, Denmark (S.P.J., L.P., H.T.S.); Department of Epidemiology and Social Medicine, University of Aarhus, Denmark (S.P.J.); Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark (S.F., J.H.O.); International Epidemiology Institute, Rockville, Md (W.J.B., J.K.M); Department of Medicine, Vanderbilt University Medical Center, Vanderbilt-Ingram Cancer Center, Nashville, Tenn (W.J.B., J.K.M., J.H.O.); Department of Medicine M, Aalborg Hospital, Aalborg, Denmark (H.T.S.); and Department of Medicine V, Aarhus University Hospital, Aarhus, Denmark (H.T.S.).

^* To whom correspondence should be addressed. E-mail: spj{at}soci.au.dk.

Background and Purpose--Nonsteroidal anti-inflammatory drugs (NSAIDs) have effects on hemostasis and have been associated with an increased risk of bleeding. However, data relating the use of nonaspirin NSAIDs and risk of intracerebral hemorrhage (ICH) are sparse.

Methods--Using data from the County Hospital Patient Register and the Civil Registration System of North Jutland County, Denmark, we identified 912 cases of first-time ICH and 9059 sex- and age-matched population-based controls in the period of 1991 to 1999. All prescriptions for nonaspirin NSAIDs before the date of admission for ICH were identified through a population-based prescription database. Conditional logistic regression was used to adjust for potential confounding factors, including previous discharge diagnoses of hypertension, chronic bronchitis and emphysema, alcoholism, liver cirrhosis, diabetes mellitus, and prescriptions for insulin or oral hypoglycemic agents, antihypertensive agents, lipid-lowering agents, low-dose aspirin, high-dose aspirin, and oral anticoagulants.

Results--No overall association was found between prescription for nonaspirin NSAIDs in the preceding 30, 60, or 90 days and risk of ICH; ie, odds ratios ranged from 0.92 (95% CI, 0.70 to 1.21) to 1.13 (95% CI, 0.81 to 1.58). Furthermore, there was no increased risk of ICH associated with prescription for nonaspirin NSAIDs when the study population was stratified by age, sex, and a previous discharge diagnosis of hypertension.

Conclusions--Patients prescribed nonaspirin NSAIDs were not at an overall increased risk of being hospitalized for ICH. This reassuring finding was seen in all examined subgroups, including the elderly and patients with a previous discharge diagnosis of hypertension.

Key words: anti-inflammatory agents, nonsteroidal • case-control studies • epidemiology • intracerebral hemorrhage

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