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THE SOUTH AFRICAN GASTROENTEROLOGY REVIEW 2022 | VOLUME 20 | ISSUE 2 | 12 as OTC versus prescription use are shown in table 3. There were twelve mortalities of which five were unable to give consent (three were intubated and ventilated on arrival and two were in a state of confusion). The remaining seven patients all used OTC NSAIDs. We elected to exclude these patients from the cost analysis as all required prolonged organ support, multiple interventions and would have skewed the results. The cost of treatment for all UGIT bleeds during the six-month period was R 10 463 668 (n=253). Patients using NSAID’s (n=215) accounted for 88% (R 9 194 698) of the cost. Of the patients who used NSAID’s, 85% (n=183) obtained their medication OTC, and their treatment cost R 7 592 260, 73% of the total. This is five times the cost of treating UGIT bleeds in patients who used prescription only NSAID’s. Figure 1: Study flow diagram CHBAH Chris Hani Baragwanath Academic Hospital; CMJAH Charlotte Maxeke Johannesburg Academic Hospital; PHT portal hypertension; NSAID non-steroidal anti-inflammatory; OTC over the counter Table 1: Demographic and Clinical information NSAID non steroidal anti-inflammatory drug; SD: Standard Deviation; LOS: total Length Of Stay, ICU: Intensive Care Unit, PRC: Packed Red Cells, FFP: Fresh Frozen Plasma. Mean [range (SD)] NSAID users Non-NSAID users TOTAL OTC By prescription N 215 183 32 38 Age 51 [14-88(18)] 50 [14-87(17.4)] 60 † [19-88(20.5)] 46 * [18-84(19.8)] Hospital admission LOS 6.3 [2-54(5)] 6.23 [2-54(6.23)] 6.5 † [2-30(5.39)] 5.74 * [2-16(5)] ICU LOS 0.3 [0-19(0.3)] 0.29 [0-19(1.82)] 0.13 † [0-2(0.49)] 0.11 * [0-4(0.65)] Endoscopy OGD 1 [0-4(0.7)] 0.97 [0-4(0.7)] 1.09 † [0-3(0.69)] 1 * [0-2(0.57)] Intervention 0.02 [0-1(0.15)] 0.02 [0-1(0.15)] 0.03 † [0-1(0.18)] 1 * [0-1(0.23)] Injection 0.12 [0-1(0.32)] 0.10 [0-1(0.3)] 0.22 † [0-1(0.42)] 0 * Surgery Laparotomy 0.11 [0-1(0.32)] 0.11 [0-1(0.31)] 0.09 † [0-1(2.9)] 0.08 * [0-1(0.27)] Relook laparotomy 0.05 [0-7(0.49)] 0.05 [0-7(0.53)] 0 † 0 * Blood Products PRC 1.96 [0-17(2.64)] 1.94 [0-15(0.5)] 1.66 † [0-7(2.06)] 1.61 * [0-9(2.2)] FFP 0.39 [0-7(1.13)] 0.39 [0-7(1.13)] 0.25 † [0-4(0.84)] 0 * Platelets 0.05 [0-2(0.28)] 0.04 [0-2(0.27)] 0.06 † [0-2(0.35)] 0.03 * [0-1(0.16)] Subgroup cost R9 194 698 R 7 592 260 R 1 602 438 † R 1 268 970 * TOTAL COST R 10 463 668 † NS (p-value>0.05) OTC versus prescription NSAID use; * NS (p-value>0.05) NSAID versus non-NSAID use. LOS length of stay; ICU intensive care unit, OGD oesophagogastroduodenoscopy; PRC packed red cell unit; FFP fresh frozen plasma unit; R Rand Table 2: Pattern of OTC analgesic use Over the counter analgesic use Grand-Pa™ (Asprin-paracetamol-caffeine combination) 57.4% Paracetamol 34.4% Ibuprofen 8.7% Aspirin 32.8% Other NSAID and/or combination analgesics (Paracetamol/Codeine, Paracetamol/Ibuprofen, Paracetamol/Aspirin, Paracetamol/Ibuprofen/ Codeine, Diclofenac and Indomethacin). 32.8% Table 3: Comparisons between patient profiles according to information obtained in the questionnaire. Chi Square tests were performed to examine significance of each parameter. NSAID vs NON NSAID USE OTC NSAID vs PRESCRIPTION NSAID USE Demographics Age 0.05 0.005 Gender NS NS Employment NS NS Co-Morbidity Diabetes NS 0.05 Hypertension NS 0.0004 Retroviral Disease 0.04 NS Arthritis NS 0.0004 Peptic Ulcer Disease NS 0.04 REVIEW 321 Admissions (215 CHBAH & 106 CMJAH) n=253 68 Exclusion: 15 bleeding varices/ PHT/malignancy 41 declined consent 12 mortalities No NSAID n=38 OTC NSAID n=183 NSAID use n=215 Prescription NSAID n=32 social and dminis- g prevalence of atory drug use in rrhage. Ar hives of ity associated with emiologic and Eco- orth America.2001; ernal Analgesia,Ati- r Over-the-Counter ister.2009;74(81): w.gpo.gov/fdsys/ ssed on 19 January tial Medicines List for tional Department ble from : www. .pdf [Accessed 19 f prescribed erly patients. British 85-192. n between age- Internal Medi- al. Selective out- nal bleeding in the gy. 1999; 94(5): outh Africa. Statis- ailable from: www. ] on-steroidal anti-in- a risk factor analysis Journal of Gastroen- . Risk for serious e of nonsteroidal nnals of Internal affect risk of non- stroenterology.2013; erienced by AIDS 04; 94(6): 450–454. nagement of HIV linic in Tshwane, 13;14: 94-101. 4) South African Na- viour Survey, 2012 ti-inflammatory for peptic ulcer al of Epidemiology. ntestinal bleeding atment. Drugs astrointestinal dam- erly series : article y.1993; 17: 13-20. Care in South Africa urnal of Medicine. algesics-in-south-af- obacter pylori infec- gs in peptic-ulcer : 14-22. REVIEW