Do anticoagulant medications (DOACs or warfarin) worsen outcomes in patients with gastrointestinal bleeding compared to non-anticoagulated patients?
Prior use of DOACs or warfarin in patients presenting with gastrointestinal bleeding is associated with increased bleeding severity, higher mortality, and delayed endoscopy.
Gastrointestinal bleeding (GIB) is a common medical emergency, with vitamin K antagonists (such as warfarin) and direct oral anticoagulants (DOACs) being important risk factors. We investigated the impact of anticoagulant medications on patient outcomes in upper and lower GIB. Using TriNetX, a global research database, we examined outcomes in patients with GIB with and without anticoagulant medications, propensity-matched based on age, sex, race and co-morbidities. Patients taking either DOACs or warfarin had more severe GIB and greater mortality than non-anticoagulated patients, even after controlling for comorbid status. Anticoagulated patients also had higher rates of delayed endoscopy.
Holtslander et al. (Wed,) studied this question.