Table 2. Alcohol Consumption and Risk of Major GI Bleeding.
| Alcohol intake (g/day) | ||||||
|---|---|---|---|---|---|---|
| 0 | 1–4 | 5–14 | 15–29 | ≥30 | P value for linear trenda | |
| Person-years | 151156 | 244945 | 260621 | 139467 | 87607 | |
| All GI bleedingb | ||||||
| No. of cases | 32 | 73 | 94 | 72 | 34 | |
| Age-adjusted HR (95% CI)c | 1.0 | 1.15 (0.76, 1.75) | 1.35 (0.91, 2.02) | 1.78 (1.17, 2.70) | 1.56 (0.96, 2.54) | 0.002 |
| Multivariable1 HR (95% CI)d | 1.0 | 1.10 (0.72, 1.67) | 1.29 (0.86, 1.94) | 1.67 (1.09, 2.55) | 1.43 (0.88, 2.35) | 0.006 |
| Multivariable 2 HR (95% CI)e | 1.0 | 1.08 (0.71,1.64) | 1.27 (0.84,1.91) | 1.64 (1.07,2.52) | 1.41 (0.86,2.31) | 0.007 |
| Upper GI bleedingf | ||||||
| No. of cases | 16 | 31 | 44 | 36 | 15 | |
| Age-adjusted HR (95% CI)c | 1.0 | 0.98 (0.54, 1.79) | 1.28 (0.72, 2.28) | 1.79 (0.99, 3.23) | 1.38 (0.68, 2.79) | 0.01 |
| Multivariable 1 HR (95% CI)d | 1.0 | 0.95 (0.52, 1.73) | 1.27 (0.71, 2.27) | 1.76 (0.96, 3.22) | 1.35 (0.66, 2.77) | 0.02 |
| Multivariable 2 HR (95% CI)e | 1.0 | 0.93 (0.51, 1.71) | 1.27 (0.71, 2.27) | 1.77 (0.97, 3.24) | 1.37 (0.67, 2.82) | 0.01 |
| Lower GI bleedingf | ||||||
| No. of cases | 13 | 36 | 39 | 26 | 12 | |
| Age-adjusted HR (95% CI)c | 1.0 | 1.41 (0.75, 2.67) | 1.38 (0.74, 2.59) | 1.58 (0.81, 3.08) | 1.36 (0.62, 2.98) | 0.42 |
| Multivariable 1 HR (95% CI)d | 1.0 | 1.33 (0.71, 2.52) | 1.29 (0.68, 2.43) | 1.45 (0.73, 2.85) | 1.18 (0.53, 2.62) | 0.65 |
| Multivariable 2 HR (95% CI)e | 1.0 | 1.27 (0.67, 2.40) | 1.25 (0.66, 2.36) | 1.38 (0.70, 2.73) | 1.13 (0.51, 2.51) | 0.69 |
a P value for trend calculated using the median value in each category of alcohol consumption as a continuous variable in the regression models
b Includes 28 cases of bleeding of unknown etiology and 9 cases of small bowel bleeding
c Adjusted for age in years and study period in 4-year intervals; using cumulative updating to examine alcohol consumption
d Adjusted for smoking (past/current), body mass index (<21, 25–29, 30–31, ≥32 kg/m2), physical activity (quintiles), regular use of aspirin (at least 2 times per week; yes/no), regular use of NSAIDs (at least 2 times per week; yes/no); using cumulative updating to examine alcohol consumption
e Adjusted for multivariate model 1 plus medication use (proton pump inhibitors, H2 receptor antagonists, selective serotonin reuptake inhibitors, warfarin and/or clopidogrel) and comorbid disease (myocardial infarction, stroke or transient ischemic attack, rheumatoid arthritis, degenerative joint disease, peripheral vascular disease, chronic obstructive pulmonary disease, chronic kidney disease).
f Upper GI bleeding was defined as bleeding originating from the esophagus, stomach, or duodenum; lower GI bleeding was defined as bleeding arising from the colon or rectum.