Key result
Anticoagulant or antiplatelet therapy in patients with acute gastrointestinal bleeding was associated with an in-hospital mortality of 8.3% compared with 10.3% in patients not on such therapy.
Why the study?
The authors sought to investigate the demographic characteristics, endoscopic and laboratory findings, comorbidities, and mortality rate of patients with gastrointestinal bleeding related to anticoagulant or antiplatelet therapy.
Does prior anticoagulant or antiplatelet therapy worsen in-hospital mortality in patients admitted for acute gastrointestinal bleeding?
Observational (n=1,367)
No
Does prior anticoagulant or antiplatelet therapy worsen in-hospital mortality in patients admitted for acute gastrointestinal bleeding?
Absolute Event Rate: 8.3% vs 10.3%
In patients admitted for acute gastrointestinal bleeding, prior use of anticoagulant or antiplatelet therapy does not worsen in-hospital mortality, which is instead primarily driven by age and comorbidities.
Describes GI bleeding features in antithrombotic users; leaves open causal links and practice implications pending prospective data.
AIM: To investigate the demographic characteristics, endoscopic and laboratory findings, comorbidities and mortality rate of patients with gastrointestinal bleeding related to anticoagulant or antiplatelet therapy. METHODS: We reviewed the records of patients admitted for gastrointestinal bleeding to the Intensive Care Unit of the Department of Gastroenterology, University Hospital Split, between 2015 and 2019. The characteristics and clinical outcomes of patients taking anticoagulant/antiplatelet therapy were analyzed. RESULTS: The study enrolled 1367 patients, 434 (31.7%) of whom received anticoagulant/antiplatelet therapy (mean age 74.9±10.7 years; 64.3% men). The most frequently prescribed drug was acetylsalicylic acid (56.7%), the most common bleeding site was the stomach (41.3%), and the most prevalent cause of bleeding was ulcer (61.6%). Patients taking anticoagulant/antiplatelet therapy who died had significantly higher creatinine (P=0.011) and lower albumin (P=0.015). In the multivariate analysis, the factors that negatively affected survival were older age, higher creatinine, and lower albumin. Patients taking anticoagulant/antiplatelet therapy had slightly lower in-hospital mortality (8.3%) compared with other patients (10.3%). CONCLUSION: Although anticoagulant/antiplatelet therapy increases the risk of gastrointestinal bleeding, it does not directly affect the outcome, which is mainly determined by age and comorbidities.
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Božić et al. (2021) conducted an observational in Acute gastrointestinal bleeding (n=1,367). Anticoagulant or antiplatelet therapy vs. No anticoagulant or antiplatelet therapy was evaluated on In-hospital mortality. Anticoagulant or antiplatelet therapy in patients with acute gastrointestinal bleeding was associated with an in-hospital mortality of 8.3% compared with 10.3% in patients not on such therapy.
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