Please use this identifier to cite or link to this item: http://hdl.handle.net/10400.16/2157
Title: Antiplatelet agents and/or anticoagulants are not associated with worse outcome following nonvariceal upper gastrointestinal bleeding
Author: Teles-Sampaio, E.
Maia, L.
Salgueiro, P.
Marcos-Pinto, R.
Dinis-Ribeiro, M.
Pedroto, I.
Keywords: Anticoagulants
Comorbidity
Endoscopy
Gastrointestina
Gastrointestinal hemorrhage
Outcome assessment.
Platelet aggregation inhibitors
Issue Date: Nov-2016
Publisher: Aran Ediciones
Citation: Rev Esp Enferm Dig. 2016 Nov;108(11):703-708
Abstract: BACKGROUND: Nonvariceal upper gastrointestinal bleeding emerges as a major complication of using antiplatelet agents and/or anticoagulants and represents a clinical challenge in patients undergoing these therapies. AIM: To characterize patients with nonvariceal upper gastrointestinal bleeding related to antithrombotics and their management, and to determine clinical predictors of adverse outcomes. METHODS: Retrospective cohort of adults who underwent upper gastrointestinal endoscopy after nonvariceal upper gastrointestinal bleeding from 2010 to 2012. The outcomes were compared between patients exposed and not exposed to antithrombotics. RESULTS: Five hundred and forty-eight patients with nonvariceal upper gastrointestinal bleeding (67% men; mean age 66.5 ± 16.4 years) were included, of which 43% received antithrombotics. Most patients had comorbidities. Peptic ulcer was the main diagnosis and endoscopic therapy was performed in 46% of cases. The 30-day mortality rate was 7.7% (n = 42), and 36% were bleeding-related. The recurrence rate was 9% and 14% of patients with initial endoscopic treatment needed endoscopic retreatment. There were no significant differences between the exposed and non-exposed groups in most outcomes. Co-morbidities, hemodynamic instability, high Rockall score, low hemoglobin (7.76 ± 2.72 g/dL) and higher international normalized ratio (1.63 ± 1.13) were associated significantly with mortality in a univariate analysis. CONCLUSIONS: Adverse outcomes were not associated with antithrombotic use. The management of nonvariceal upper gastrointestinal bleeding constitutes a challenge to clinical performance optimization and clinical cooperation.
Peer review: yes
URI: http://hdl.handle.net/10400.16/2157
DOI: 10.17235/reed.2016.4424/2016
ISSN: 1130-0108
Publisher Version: https://online.reed.es/Revistas/REED_2016_108_11/Contenido/pdf/vol108num11_en_4.pdf
Appears in Collections:SN - Artigos publicados em revistas indexadas na Medline
SG - Artigos publicados em revistas indexadas na Medline

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