Gross Lower Gastrointestinal Bleeding in Patients on Anticoagulant and/or Antiplatelet Therapy: Endoscopic Findings, Management, and Clinical Outcomes. Journal of clinical gastroenterology [J Clin Gastroenterol] Journal article | | Title | Gross Lower Gastrointestinal Bleeding in Patients on Anticoagulant and/or Antiplatelet Therapy: Endoscopic Findings, Management, and Clinical Outcomes. | | Author(s) | Hashash JG, Shamseddeen W, Skoury A, Aoun N, Barada K | | Institution | Department of Internal Medicine, Division of Gastroenterology, American University of Beirut Medical Center, Beirut, Lebanon. | | Source | J Clin Gastroenterol 2008 Aug 11. | | Abstract | OBJECTIVES: Gross gastrointestinal (GI) bleeding is a serious complication of anticoagulant/antiplatelet drug therapy. This study compares the frequencies of colorectal pathologies, endoscopic and resuscitative management measures, and clinical outcomes of patients hospitalized with lower GI bleeding (LGIB) while using anticoagulants/antiplatelets with those of patients not using them.
METHODS: A retrospective review of the records of 166 admissions for patients with gross LGIB over 12 years was conducted. The colonoscopic findings, management measures, and clinical outcomes were compared between 2 groups. Group A composed of 100 patients using any antiplatelet/anticoagulant, and group B 66 patients not using any such drugs. Independent t tests and chi were used to test for association between taking antiplatelet/anticoagulant and other variables.
RESULTS: Patients in group A were older and had more comorbidities than patients in group B. Severe LGIB occurred in 55.1% and 35.4% in groups A and B, respectively (P=0.01). Severity was not related to old age or the presence of comorbidities. A higher percentage of patients in group A had a hospital stay >/=6 days (44% vs. 27.3%; P<0.03), required blood transfusions (68% vs. 51.5%; P=0.03), and had in-hospital complications (37% vs. 22.7%; P=0.052). The most common source of bleeding was diverticulosis in both groups. Colorectal abnormalities were present in most patients; and in those using warfarin, colon cancer was common.
CONCLUSIONS: Use of antiplatelets/anticoagulant drugs is an independent predictor of severe LGIB and is associated with adverse outcomes. Colonoscopy is required in patients who bleed while using such drugs. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 18698263 |
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