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Application of Antithrombotic Drugs in Different Age-Group Patients with Upper Gastrointestinal Bleeding

Ding Peng1, Huihong Zhai1

  • 1Department of Gastroenterology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.

Gastroenterology Research and Practice
|April 12, 2024
PubMed

Insights

In elderly patients with upper gastrointestinal bleeding (UGIB), resuming anticoagulants increased rebleeding risk. However, antithrombotic drugs did not raise mortality. Young patients can safely resume anticoagulants sooner.

Area of Science:

  • Gastroenterology
  • Cardiology
  • Geriatrics

Background:

  • Upper gastrointestinal bleeding (UGIB) is a significant clinical challenge, particularly in elderly populations.
  • Antithrombotic medications are crucial for preventing thrombotic events but pose a bleeding risk.
  • The optimal management of antithrombotic therapy in UGIB patients, considering age, remains debated.

Purpose of the Study:

  • To investigate the safety and optimal timing of antithrombotic drug use in patients with UGIB across different age groups.
  • To identify risk factors for mortality and rebleeding in UGIB patients, with a focus on antithrombotic therapy.

Main Methods:

  • Retrospective observational study utilizing a single-center database.
  • Inclusion of 713 patients diagnosed with UGIB.
  • Analysis of medication history, resumption patterns, and clinical outcomes, stratified by age.

Main Results:

  • Elderly patients (>60 years) constituted 62.13% of the cohort, with an overall mortality of 2.9%.
  • In elderly UGIB patients, antithrombotic resumption did not impact in-hospital mortality, but anticoagulant resumption elevated rebleeding risk.
  • Independent risk factors for mortality included CHF, cirrhosis, creatine kinase, and albumin; for rebleeding, they included anticoagulant use, variceal bleeding, stool color, RBC, platelets, and heart rate.

Conclusions:

  • Antithrombotic drug history and post-UGIB antiplatelet use did not significantly affect prognosis in UGIB patients.
  • While antithrombotics did not increase mortality in elderly UGIB patients, careful management of rebleeding risk upon resumption is warranted.
  • Early resumption of anticoagulant therapy is considered safe for young UGIB patients.
Abstract

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