CHARACTERISTICS AND FEATURES OF UPPER GASTRO INTESTINAL BLEEDING IN PATIENTS ON ANTITHROMBOTIC DRUGS: A PROSPECTIVE STUDY

Aims The aim of our study is to evaluate the effect of AT use on endoscopic outcomes in patients admitted for UGIB.

Methods This is a prospective monocentric cross-sectional study of 332 patients conducted between June 2020 and August 2021.

We considered as users of AT drugs all patients on antiplatelet agents (low-dose aspirin, thienopyrimidines) and/or anticoagulants (vitamin K antagonists, direct-acting anticoagulants, heparin).

Demographic, clinical, endoscopic and therapeutic data was collected, and analysed in a database on the SPSS version 22.0 program.

Results The average age was 59+/−16.7 years. Our series was characterised by a clear male predominance of 77.1%.

63 patients (19%) were taking AT drugs (41 antiplatelet, 39 anticoagulant).

The two groups differed in age (68 vs 57; p<0.001), comorbidities (75.8% vs 16.7%; p<0.001), however there was no statistically significant difference in active bleeding at endoscopy (12.7%vs 16.8%; p=0.425), and the need for endoscopic haemostasis (7.9%vs 16%; p=0.1).

In multivariate analysis and adjusting for age, sex, comorbidities, presence of active bleeding and use of antithrombotics, only the presence of active bleeding could predict the need for endoscopic haemostasis. Indeed, the presence of active bleeding at the time of endoscopy multiplies by 26 the risk of recourse to endoscopic haemostasis (OR: 26, CI: 12.9–62.15, p<0.001), whereas the use of AT drugs does not influence the need for endoscopic haemostasis (OR: 0.386, CI: 0.105- 1.42, p=0.154).

Conclusions Older patients using AT admitted for UGIB do not appear to have an increased risk of active bleeding at endoscopy or needing endoscopic haemostasis.

Publication History

Article published online:
14 April 2022