Key result
Among elderly patients with upper gastrointestinal bleeding, 72.8% were using potentially causative drugs, most commonly acetylsalicylic acid (31.5%) and NSAIDs (20.7%), with an overall mortality of 6.5%.
Why the study?
What is the role of antiaggregant and anticoagulant drugs in the etiology and prognosis of upper gastrointestinal bleeding in elderly patients?
Observational (n=184)
No
What is the role of antiaggregant and anticoagulant drugs in the etiology and prognosis of upper gastrointestinal bleeding in elderly patients?
Antiaggregant and anticoagulant drugs are frequently implicated in upper gastrointestinal bleeding in the elderly, highlighting the need for careful indication review and potential gastroprotective therapy.
Supports careful medication review in at-risk elderly; extends observational etiology data but leaves causal prognosis open.
Introduction: In this study, we aimed to determine the role of anticoagulants and antiagregan medications in the etiology and prognosis of the upper gastrointestinal system (GIS) bleeding in elderly patients. Methods: One hundred and eighty-four patients who were admitted to the emergency department with the complaints of upper GIS bleeding between January and December 2016 were evaluated retrospectively regarding the age, gender, complaints, drugs, endoscopy findings, intensive care requirement and mortality. Results: The mean age of 184 patients was 78.37.9 years. 112 (60.9%) of them were male and 72 (39.1%) of them were female. 128 (69.6%) of the patients applied with only melena, 32(17.4%) with only hematemesis and 24 (13%) were admitted with both hematemesis and melena. Of the patients, 139 (75.9%) were treated in the internal medicine clinic and 31 (16.8%) were treated in the intensive care unit and 12 (6.5%) were expired. The most commonly used drug was acetylsalicylic acid (ASA) (31.5%) and the most common endoscopic finding was peptic ulcer (55.4%). The mean age of the patients treated in the intensive care unit was 817.2years, and 18 (58.1%) of those patients were male. The most common endoscopic finding was peptic ulcer-Forrest 2A (16.2%) and ASA (35.5%) was also the most common drug in that group. The mean age of the 12 patients who were expired was 75.37.2 years and 8 (66.7%) of them were male. In 12 patients, the most common endoscopic finding was the peptic ulcer and the most frequent drug was warfarin (33%). Discussion and Conclusion: Antiagregan, anticoagulant, NSAI drugs have significant effects on etiology and prognosis of the upper GIS bleeding in the elderly. Gastroprotective drugs should be added to the treatment of patients using these drugs.
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Hanife Şerife Aktaş (2018) conducted an observational in Upper gastrointestinal system bleeding (n=184). Antiaggregant and anticoagulant drugs was evaluated on Etiology and prognosis of upper gastrointestinal bleeding (drug use, endoscopic findings, and mortality). Among elderly patients with upper gastrointestinal bleeding, 72.8% were using potentially causative drugs, most commonly acetylsalicylic acid (31.5%) and NSAIDs (20.7%), with an overall mortality of 6.5%.
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