Related Experiment Video
Updated: Apr 27, 2026

Standardized Hemorrhagic Shock Induction Guided by Cerebral Oximetry and Extended Hemodynamic Monitoring in Pigs
Published on: May 21, 2019
Gastrointestinal hemorrhage in warfarin anticoagulated patients: incidence, risk factor, management, and outcome
Wen-Chi Chen1, Yan-Hua Chen2, Ping-I Hsu3
1Division of Gastroenterology, Department of Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaohsiung 81362, Taiwan ; Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan ; Department of Chemistry, College of Science, National Kaohsiung Normal University, Kaohsiung 82444, Taiwan.
Background:
Warfarin reduces the incidence of thromboembolism but increases the risk of gastrointestinal bleeding (GIB). GIB during warfarin anticoagulation is rarely evaluated in Asian patients.
Aims:
This study aimed at investigating the incidence, risk factors, management, and outcome of GIB in Taiwanese patients treated with warfarin.
Methods:
We analyzed a cohort of warfarin anticoagulated patients between July 1993 and May 2012. Clinical data were retrieved in a chart-reviewing manner.
Results:
A total of 401 warfarin anticoagulated patients were enrolled. The incidence of GIB was 3.9% per patient-years. Multivariate analysis with Cox regression showed that age >65 years old (RR: 2.5, 95% CI: 1.2-5.5), a mean international normalized ratio >2.1 (RR: 2.1, 95% CI: 1.0-4.2), a history of GIB (RR: 5.1, 95% CI: 1.9-13.5), and cirrhosis (RR: 6.9, 95% CI: 2.0-24.5) were independent factors predicting GIB. 27.3% of the GIB patients had rebleeding after restarting warfarin while thromboembolic events were found in 16.7% of the patients discontinuing warfarin therapy.
Conclusions:
Warfarin was associated with a significant incidence of GIB in Taiwanese patients. The intensity of anticoagulation should be monitored closely during warfarin therapy, especially in patients with risk factors of GIB.
Related Concept Videos
Venous Thrombosis IV: Nursing Management
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Venous Thrombosis III: Interprofessional Care
Anticoagulant Drugs: Low-Molecular-Weight Heparins
Disorders of Hemostasis
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
Esophageal Varices-II: Clinical Features and Management
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...

