Year 2022 / Volume 114 / Number 10
Original
Severity of gastrointestinal bleeding is similar between patients receiving direct oral anticoagulants or vitamin K antagonists

599-604

DOI: 10.17235/reed.2022.8388/2021

Luis G. Alcalá-González, César Jiménez, Vicente Cortina, Alba Jiménez, María Cerdá, Erik Johansson, Pável Olivera, Amparo Santamaría, Carmen Alonso-Cotoner,

Abstract
Background: Gastrointestinal bleeding (GIB) is a common adverse event related to anticoagulation therapy. However, evidence comparing the severity, etiology and outcome of GIB in patients taking direct oral anticoagulants (DOAC) vs. vitamin K antagonists (VKA) is scarce. AIMS: To evaluate the severity, etiology and outcomes of GIB in patients under DOACs compared to VKA. Methods: Patients under oral anticoagulant therapy admitted to the emergency department with acute GIB were prospectively recruited from July 2016 to January 2018 at a tertiary referral hospital. Demographic and clinical outcome were obtained from medical records. Severity of the GIB event was classified as mild, major or severe according to clinical presentation and the type of support needed. Etiology and location of bleeding, number of packed red blood cells transfused (PRBC) and length of hospital stay were recorded until discharge or in-hospital death. Results: A total of 208 patients with acute GIB under oral anticoagulant treatment were recruited: 119 patients were on VKA and 89 patients on DOAC with similar characteristics. Thirty-one patients had severe GIB; 134 major and 43 mild, with no differences in severity, number of PRBC and length of hospital stay between the groups. Peptic disease was the most frequent etiology of GIB in patients on VKA (20.2 % vs. 13.6%, p=0.20). Diverticular bleeding was the most frequent adverse event in patients on DOAC (14.3% vs. 24.8%, p= 0.056). Conclusions: Severity and clinical outcomes of GIB are similar between patients on DOAC and patients on VKA, regardless of etiology of GIB.
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Good data from real life cohort


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Alcalá-González L, Jiménez C, Cortina V, Jiménez A, Cerdá M, Johansson E, et all. Severity of gastrointestinal bleeding is similar between patients receiving direct oral anticoagulants or vitamin K antagonists. 8388/2021


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Publication history

Received: 12/10/2021

Accepted: 27/01/2022

Online First: 28/01/2022

Published: 07/10/2022

Article revision time: 104 days

Article Online First time: 108 days

Article editing time: 360 days


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