Key result
Obesity and antithrombotic therapy are not linked to bleeding severity in gastrointestinal bleeding.
Why the study?
Obesity and the use of antiplatelet and anticoagulant agents are both increasing, but their effects on clinical presentation, bleeding severity, and short-term outcomes in gastrointestinal bleeding required evaluation.
Does obesity or antithrombotic therapy independently increase bleeding severity and worsen short-term clinical outcomes in patients with gastrointestinal bleeding?
Cohort (n=177)
No
Does obesity or antithrombotic therapy independently increase bleeding severity and worsen short-term clinical outcomes in patients with gastrointestinal bleeding?
In patients with gastrointestinal bleeding, short-term clinical outcomes and bleeding severity are driven more by patient-related factors such as advanced age rather than obesity or the use of antithrombotic therapy alone.
Answers are grounded in this paper and cite their sources.
Findings should not yet change practice for obese or antithrombotic-treated patients with GI bleeding; leaves open confirmation of age as dominant factor in larger cohorts.
Background and Objectives: Obesity is a major global public health problem associated with numerous complications. Likewise, the use of antiplatelet and anticoagulant agents has increased with population aging and the growing burden of cardiovascular diseases. This study aimed to evaluate the effects of obesity and antiplatelet/anticoagulant therapy on the clinical presentation, bleeding severity, and short-term clinical outcomes of patients with gastrointestinal bleeding. Materials and Methods: A prospective cohort study was conducted in consecutive patients admitted with upper or lower gastrointestinal bleeding to a tertiary referral center between January 2024 and January 2025. Patients were categorized according to body mass index (BMI) and antithrombotic therapy status. Clinical characteristics, bleeding severity scores, treatment requirements, and short-term clinical outcomes were compared. Multivariable multinomial logistic regression analysis was performed to identify independent associations. Results: A total of 177 patients were included. Obese and overweight patients were significantly older than normal-weight patients (p = 0.001), whereas no significant differences were observed among BMI groups regarding the Glasgow–Blatchford score, pre-endoscopic Rockall score, transfusion requirements, endoscopic intervention, or short-term clinical outcomes. Patients receiving antiplatelet or anticoagulant therapy had significantly higher Charlson Comorbidity Index, bleeding severity scores, and packed red blood cell transfusion requirements than those receiving no antithrombotic therapy (all p < 0.01). However, after multivariable adjustment, these associations did not remain independent, and advanced age remained the only independent factor common to both treatment groups. Conclusions: Obesity was not independently associated with bleeding severity or short-term clinical outcomes in patients with gastrointestinal bleeding. Although antiplatelet and anticoagulant therapy were associated with more severe bleeding-related clinical findings, these associations were not independent after multivariable adjustment.
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Yüksel et al. (2026) conducted a cohort in Gastrointestinal bleeding (n=177). Obesity and antithrombotic therapy vs. Normal weight and no antithrombotic therapy was evaluated on Bleeding severity and short-term clinical outcomes. Obesity and antithrombotic therapy were not independently associated with bleeding severity or short-term clinical outcomes in patients with gastrointestinal bleeding after multivariable adjustment.
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