Esophagogastroduodenoscopy findings in patients with or without recent use of antiplatelets, anticoagulants, or NSAIDs and non-variceal upper gastrointestinal bleeding: A retrospective cohort study.

IF 1.2 4区医学 Q4 GASTROENTEROLOGY & HEPATOLOGY

Acta gastro-enterologica Belgica Pub Date : 2025-07-01 DOI:10.51821/88.3.13990

K Mpakogiannis, F S Fousekis, P Moshou, K H Katsanos, D K Christodoulou, I V Mitselos

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引用次数: 0

Abstract

Background: Use of antiplatelets, anticoagulants, or aspirin/NSAIDs increases the risk of major gastrointestinal (GI) bleeding. This study aimed to analyze esophagogastroduodenoscopy (EGD) findings in patients treated with these drugs (drug-exposed) versus those who were not (non-exposed), who presented with signs suggestive of nonvariceal upper GI bleeding.

Patients and methods: This retrospective cohort study included patients aged over 16 years with signs suggestive of upper GI bleeding, no history of gastrointestinal malignancy, and no portal hypertension or varices, hospitalized at the General Hospital of Ioannina, Greece, from January 2019 to October 2023. Differences between the two patient groups were tested for significance with the chi-square test. Relative Risk (RR) and Odds Ratio (OR) were calculated to assess the association between drug exposure and endoscopic findings. A p-value less than 0.05 was consider ed statistically significant.

Results: A total of 405 patients (268 males; mean age 73.1 ± 16.8 years) were enrolled: 303 drug-exposed (193 males; mean age 77.6 ± 12.2) and 102 non-exposed (75 males; mean age 59.7 ± 20.9). Peptic ulcer disease (PUD) was the most common bleeding cause. Drug exposure was strongly associated with vascular lesions (angiodysplasias, Dieulafoy's lesion, GAVE) (RR: 12.12, 95% CI: 1.68-87.3, p = 0.01; OR: 13.62, 95% CI: 1.84-100.64, p = 0.002). Notably, 75% of angiodysplasia cases occurred in anticoagulant-treated patients, with 50% receiving DOACs.

Conclusion: Upper GI bleeding in patients on antiplatelets, anticoagulants, or NSAIDs/aspirin should prompt suspicion of pre-existing lesions, particularly PUD and angiodysplasias.

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食管胃十二指肠镜检查发现有或没有近期使用抗血小板、抗凝剂或非甾体抗炎药和非静脉曲张上消化道出血的患者：一项回顾性队列研究

背景：使用抗血小板、抗凝血剂或阿司匹林/非甾体抗炎药会增加胃肠道大出血的风险。本研究旨在分析接受这些药物治疗（药物暴露）与未接受这些药物治疗（未暴露）的患者的食管胃十二指肠镜检查结果，这些患者表现出非静脉曲张性上消化道出血的迹象。患者和方法：这项回顾性队列研究纳入了2019年1月至2023年10月在希腊约阿尼纳总医院住院的年龄超过16岁、有上消化道出血迹象、无胃肠道恶性肿瘤病史、无门脉高压或静脉曲张的患者。用卡方检验检验两组患者间差异的显著性。计算相对危险度（RR）和优势比（OR）来评估药物暴露与内镜检查结果之间的关系。p值小于0.05认为有统计学意义。结果：共纳入405例患者（男性268例，平均年龄73.1±16.8岁）：药物暴露者303例（男性193例，平均年龄77.6±12.2岁），非药物暴露者102例（男性75例，平均年龄59.7±20.9岁）。消化性溃疡（PUD）是最常见的出血原因。药物暴露与血管病变（血管发育不良，diulafoy病变，give）密切相关（RR: 12.12, 95% CI: 1.68 ~ 87.3, p = 0.01; OR: 13.62, 95% CI: 1.84 ~ 100.64, p = 0.002）。值得注意的是，75%的血管发育不良病例发生在抗凝治疗的患者中，50%的患者接受doac治疗。结论：服用抗血小板、抗凝血药物或非甾体抗炎药/阿司匹林的患者出现上消化道出血时，应怀疑已有病变，特别是PUD和血管发育不良。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta gastro-enterologica Belgica Medicine-Gastroenterology

CiteScore

2.30

自引率

20.00%

发文量

期刊介绍： The Journal Acta Gastro-Enterologica Belgica principally publishes peer-reviewed original manuscripts, reviews, letters to editors, book reviews and guidelines in the field of clinical Gastroenterology and Hepatology, including digestive oncology, digestive pathology, as well as nutrition. Pure animal or in vitro work will not be considered for publication in the Journal. Translational research papers (including sections of animal or in vitro work) are considered by the Journal if they have a clear relationship to or relevance for clinical hepato-gastroenterology (screening, disease mechanisms and/or new therapies). Case reports and clinical images will be accepted if they represent an important contribution to the description, the pathogenesis or the treatment of a specific gastroenterology or liver problem. The language of the Journal is English. Papers from any country will be considered for publication. Manuscripts submitted to the Journal should not have been published previously (in English or any other language), nor should they be under consideration for publication elsewhere. Unsolicited papers are peer-reviewed before it is decided whether they should be accepted, rejected, or returned for revision. Manuscripts that do not meet the presentation criteria (as indicated below) will be returned to the authors. Papers that go too far beyond the scope of the journal will be also returned to the authors by the editorial board generally within 2 weeks. The Journal reserves the right to edit the language of papers accepted for publication for clarity and correctness, and to make formal changes to ensure compliance with AGEB’s style. Authors have the opportunity to review such changes in the proofs.