Yes, that's the main reason aspirin isn't recommended more widely. (Stomach and liver harm are the other big reasons.)
It's not necessarily external trauma, but major bleeding events, especially internal, are more prevalent and severe on aspirin. The NNT/NNH breakdown suggests that heart attack and stroke prevention narrowly beats out increased bleeding, but it's not unambiguous.
(Normally you handle this by recommended preventatives to people at high risk so you get a better ratio. This sometimes works with aspirin, but older people are often at high risk for stroke and bleeding, so the problem sticks around.)
I don't know how cancer prevention factors in - it might push aspirin into clear net-positive territory - but regardless you're right about blood thinners creating trauma risk.
> Yes, that's the main reason aspirin isn't recommended more widely. (Stomach and liver harm are the other big reasons.)
Liver is paracetamol — aside from Reye Syndrome[0] — aspirin is metabolised via the kidneys and I believe even overdoses does not overload the kidneys[1], however aspirin inhibits excretion of uric acid which is why it's contra-indicated to people suffering from gout or kidney diseases.
[1] in fact one part of aspirin overdose protocol is urinary alkalinization: increasing urinary pH from ~5 to ~8 increases renal elimination of salicylate by 10~20x
"These results translate into an absolute rate increase with aspirin above placebo (the incidence of cases of major GI bleeding attributable to low-dose aspirin) of 0.12% per year (95% CI: 0.070.19% per year).[20] Based on this value, 833 patients (95% CI: 5261429 patients) would need to be treated with low-dose aspirin instead of placebo to cause one major GI bleeding episode during a 1-year period (i.e. the NNH is 833)"
> it might push aspirin into clear net-positive territory
It's pretty clearly in the net positive territory. Reduces sunburn, reduces obesity, can stop a heart attack or stroke immediately, cures hangovers, and reduces cancers.
Has no effect on healing as far as i can see, and i cut myself now and then regularly. (i cook alot) but i heal quickly. Now if i ever cut into a large blood vessel... Yeah ill be in trouble.
If you consider doing dental work though, please let your dentist know.
Hospitals ask about aspirin if they want to do surgery.
Bartweiss|8 years ago
It's not necessarily external trauma, but major bleeding events, especially internal, are more prevalent and severe on aspirin. The NNT/NNH breakdown suggests that heart attack and stroke prevention narrowly beats out increased bleeding, but it's not unambiguous.
(Normally you handle this by recommended preventatives to people at high risk so you get a better ratio. This sometimes works with aspirin, but older people are often at high risk for stroke and bleeding, so the problem sticks around.)
I don't know how cancer prevention factors in - it might push aspirin into clear net-positive territory - but regardless you're right about blood thinners creating trauma risk.
masklinn|8 years ago
Liver is paracetamol — aside from Reye Syndrome[0] — aspirin is metabolised via the kidneys and I believe even overdoses does not overload the kidneys[1], however aspirin inhibits excretion of uric acid which is why it's contra-indicated to people suffering from gout or kidney diseases.
[0] https://en.wikipedia.org/wiki/Reye_syndrome linked to both aspirin and liver toxicity
[1] in fact one part of aspirin overdose protocol is urinary alkalinization: increasing urinary pH from ~5 to ~8 increases renal elimination of salicylate by 10~20x
aantix|8 years ago
As for the internal bleeding risks.
https://books.google.com/books?id=j-XQ1UqLdAQC&pg=PT41&lpg=P...
"These results translate into an absolute rate increase with aspirin above placebo (the incidence of cases of major GI bleeding attributable to low-dose aspirin) of 0.12% per year (95% CI: 0.070.19% per year).[20] Based on this value, 833 patients (95% CI: 5261429 patients) would need to be treated with low-dose aspirin instead of placebo to cause one major GI bleeding episode during a 1-year period (i.e. the NNH is 833)"
smileysteve|8 years ago
It's pretty clearly in the net positive territory. Reduces sunburn, reduces obesity, can stop a heart attack or stroke immediately, cures hangovers, and reduces cancers.
idclip|8 years ago
Has no effect on healing as far as i can see, and i cut myself now and then regularly. (i cook alot) but i heal quickly. Now if i ever cut into a large blood vessel... Yeah ill be in trouble.
If you consider doing dental work though, please let your dentist know.
Hospitals ask about aspirin if they want to do surgery.