Gastrointestinal bleeding and anticoagulation in the Colombian Southwest

Abstract

Introduction and aims

Anticoagulants, essential in the treatment of different cardiovascular conditions, increase the risk of gastrointestinal bleeding. This risk varies, according to the type and administration route of the anticoagulant. National studies report bleeding rates between 0.5% and 4.7%, whereas worldwide rates vary between 4% and 17%. The present study characterizes the anticoagulated population with gastrointestinal bleeding, followed at a referral anticoagulation clinic, contributing to the regional epidemiology and clinical decision-making.

Materials and methods

A cross-sectional study was conducted on non-pregnant patients anticoagulated with warfarin, direct-acting oral anticoagulants, or parenteral anticoagulants, and who presented with gastrointestinal bleeding, within the time frame of January 2018 and June 2022.

Results

The study included 121 patients. The main indication for anticoagulation was atrial fibrillation (35%) and at least 30% had a previous bleeding episode. The upper gastrointestinal tract was the primary origin of bleeding (51%). There were no statistically significant differences in the therapeutic interventions between the different anticoagulant agents evaluated. A total of 9.1% of patients presented with rebleeding during hospitalization and in-hospital mortality was 2.5%.

Conclusions

Our findings showed that patients with gastrointestinal bleeding associated with anticoagulant use had no relevant differences regarding clinical characteristics, treatment regimen, and outcomes, according to the type of anticoagulant employed. The behavior of gastrointestinal bleeding in anticoagulated patients may be similar to that of non-anticoagulated patients. Further studies comparing these two patient groups are warranted.