Characteristics of patients with non‐variceal upper gastrointestinal bleeding taking antithrombotic agents. Issue 1 (17th September 2014)

• Record Type: Journal Article
• Authors: Yamaguchi, Daisuke; Sakata, Yasuhisa; Tsuruoka, Nanae; Shimoda, Ryo; Higuchi, Toru; Sakata, Hiroyuki; Fujimoto, Kazuma; Iwakiri, Ryuichi
• Is Part Of: Digestive endoscopy. Volume 27:Issue 1(2015)
• Page Start: 30
• Page End: 36
• Publication Date: 2014-09-17
• Subjects: Digestive organs -- Diseases -- Periodicals; Digestive organs -- Diseases -- Diagnosis -- Periodicals; Endoscopy -- Periodicals; Digestive System Diseases -- diagnosis -- Periodicals; Digestive System Diseases -- therapy -- Periodicals; Endoscopy -- Periodicals; 616.3
• DOI: 10.1111/den.12316
• Languages: English
• ISSNs: 0915-5635

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="den12316-sec-0001" sec-type="section"> <title>Background and Aim</title> <p>The present study aimed to clarify the features and management of non‐variceal upper gastrointestinal bleeding (UGIB) in Japanese patients taking antithrombotic agents.</p> </sec> <sec id="den12316-sec-0002" sec-type="section"> <title>Methods</title> <p>We retrospectively investigated the medical records of 560 patients who underwent emergency endoscopy for UGIB from 2002 to 2013. The patients were divided into two groups: group A, antithrombotic agent use; and group NA, no antithrombotic agent use. We compared clinical characteristics, comorbidities, and causes of UGIB between the groups. We also investigated management with antithrombotics.</p> </sec> <sec id="den12316-sec-0003" sec-type="section"> <title>Results</title> <p>Of 560 patients with UGIB, 27.5% were taking antithrombotics, and this proportion gradually increased during the study period. Mean hemoglobin levels on admission were significantly lower in group A (8.0 ± 1.7 g/dL) than in group NA (8.9 ± 2.9 g/dL) (<italic>P</italic> < 0.001). Patients in group A developed more gastric ulcers and multiple ulcers than did patients in group NA. Incidence of Forrest Ia‐type bleeding was lower in group A than in group NA (<italic>P</italic> < 0.001), and the rate of endoscopic hemostasis was significantly higher in group A (98.7%) than in group NA (94.3%) (<italic>P</italic> = 0.022). After the release of the 2012 Japan Gastroenterological Endoscopy Society guidelines, the antithrombotic agent cessation periods were significantly shortened (<italic>P</italic> < 0.001).</p> </sec> <sec id="den12316-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Among patients with UGIB, those taking antithrombotics exhibited more severe clinical signs. However spurting hemorrhage was rare. Antithrombotics may be resumed early after endoscopic hemostasis.</p> </sec> </abstract>