INFLUENCE OF ANTICOAGULATION THERAPY ON THE OUTCOME OF NONVARICEAL UPPER GI BLEEDING IN PATIENTS REQUIRING INTENSIVE CARE TREATMENT

Aims To assess therapeutic anticoagulation influence on therapy of patients requiring admission to the ICU due to nonvariceal upper GI bleeding.

Methods Comparison of 50 patient cases of nonvariceal upper GI bleeding admitted to ICU with therapeutic anticoagulation to 50 without over the course of 5 years.

These were compared in duration of ICU stay, hemodynamics, lactate and Hb levels, vasopressor therapy, transfusion needs, endoscopic treatment, Forrest classification of ulcer and OTSC usage.

These were compared using Chi-Square test and t-test.

Results On arrival patients undergoing anticoagulation therapy showed a similar median systolic blood pressure of 102.10 mmHg (SD=25.37), compared to 106.25 mmHg (SD=30.86; p=0.459), without relying on vasopressor support more frequently (13 / 25.5% vs. 16 / 31.4%; p=0.510). The mean Hb was 7.6 g/dl (SD=2.92) compared to 7.8 g/dl (SD=2.81). 23 patients required transfusion therapy (45.1%) compared to 22 (43.1%; p=0.842). Lactate showed higher in anticoagulation group, marginally statistically insignificant (3.9 vs 2.7; p=0.061). The amount of OTSC usage did not differ (22/22) with similar rates of FIa and FIIa ulcus among both groups (anticoagulant therapy: 16x FIa, 10x FIIa vs control group: 20x FIa, 13x FIIa). The amount of recurrent bleeding was not increased in the anticoagulation group (total 12 vs 16; 23.5% vs. 31.4%; p=0.375).

Conclusions Patients with nonvariceal upper GI bleeding admitted to the ICU receiving therapeutic anticoagulation showed similar therapeutic needs compared to those without. Particularly the recurrent bleeding episodes did not increase.

Limitations included retrospective study design and missing follow-up and data on the quality of anticoagulation.).

Publication History

Article published online:
14 April 2022