Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website http://www.gastrores.org

Original Article

Volume 12, Number 1, February 2019, pages 21-26

Acute Lower Gastrointestinal Bleeding in Patients Treated With Non-Vitamin K Antagonist Oral Anticoagulants Compared With Warfarin in Clinical Practice: Characteristics and Clinical Outcome

**Table 1.** Type of Anticoagulation Therapy of Patients
	N	%
NOACs: non vitamin K oral anticoagulants.
Warfarin	68/587	11.6
NOACs	43/587	7.3
Dabigatran	23	3.9
Apixaban	3	0.5
Rivaroxaban	17	2.9

Table 1. Type of Anticoagulation Therapy of Patients

NOACs: non vitamin K oral anticoagulants.

Warfarin

68/587

11.6

NOACs

43/587

7.3

Dabigatran

3.9

Apixaban

0.5

Rivaroxaban

2.9

**Table 2.** Clinical and Endoscopic Characteristics of Patients With Acute Lower Gastrointestinal Tract Bleeding
	Non vitamin K oral anticoagulants (NOACs), N (%)	Warfarin N (%)	P value
ALGIB: acute lower gastrointestinal bleeding; SD: standard deviation; PE: pneumonic embolism; DVT: deep vein thrombosis; Hb: hemoglobin; PLT: platelets; BUN: blood urea nitrogen; Cr: creatinine; IBD: inflammatory bowel disease.
No of all patients with ALGIB	43/587 (7.3)	68/587 (11.6)
Age (mean ± SD)	75.9 ± 9.5	77.1 ± 7.9	0.500
Male sex	26	39	0.844
History of prior GI bleeding	5	9	1.000
Indication for anticoagulation
Atrial fibrillation	37	50
PE/DVT	3	5
Prosthetic valve	3	13
Additional comorbidities	39	55	0.187
Mean Charlson comorbidity index	5.1	5.4	0.948
Laboratory tests on admission
Hb (mean ± SD)(mg/dL)	10.5 ± 3.0	10.7 ± 2.6	0.835
PLT (mean ± SD) (K/µL)	215,387 ± 92,923	199,387 ± 78,890	0.388
BUN (mean ± SD)(mg/dL)	55.3 ± 27.8	58.7 ± 42.1	0.690
Cr (median ± SD)(mg/dL)	1.25 ± 0.38	1.1 ± 0.52	0.278
Small bowel bleeding (%)	2/43 (4.6)	6 (8.8)	0.481
Causes of bleeding
Diverticular bleeding	5 (11.6)	17 (25)	0.092
Ischemic colitis	2 (4.6)	6 (8.8)	0.478
Angiodysplasia	8 (18.6)	6 (8.8)	0.010
Polyps/neoplasia	13 (30.2)	8 (11.7)	0.025
Post-polypectomy	5 (11.6)	8 (11.7)	0.474
IBD	0 (0)	1 (1.4)	1.000
Ulcers	2 (4.6)	3 (4.4)	0.786
Colitis	3 (6.9)	4 (5.8 )	0.624
Hemorrhoids	2 (4.6)	2 (2.9 )	0.707
None	1 (2.3)	6 (8.8)	0.243
Others	0 (0)	1 (1.4)	1.000

Table 2. Clinical and Endoscopic Characteristics of Patients With Acute Lower Gastrointestinal Tract Bleeding

Non vitamin K oral anticoagulants (NOACs), N (%)

Warfarin N (%)

P value

ALGIB: acute lower gastrointestinal bleeding; SD: standard deviation; PE: pneumonic embolism; DVT: deep vein thrombosis; Hb: hemoglobin; PLT: platelets; BUN: blood urea nitrogen; Cr: creatinine; IBD: inflammatory bowel disease.

No of all patients with ALGIB

43/587 (7.3)

68/587 (11.6)

Age (mean ± SD)

75.9 ± 9.5

77.1 ± 7.9

0.500

Male sex

0.844

History of prior GI bleeding

1.000

Indication for anticoagulation

Atrial fibrillation

PE/DVT

Prosthetic valve

Additional comorbidities

0.187

Mean Charlson comorbidity index

5.1

5.4

0.948

Laboratory tests on admission

Hb (mean ± SD)(mg/dL)

10.5 ± 3.0

10.7 ± 2.6

0.835

PLT (mean ± SD) (K/µL)

215,387 ± 92,923

199,387 ± 78,890

0.388

BUN (mean ± SD)(mg/dL)

55.3 ± 27.8

58.7 ± 42.1

0.690

Cr (median ± SD)(mg/dL)

1.25 ± 0.38

1.1 ± 0.52

0.278

Small bowel bleeding (%)

2/43 (4.6)

6 (8.8)

0.481

Causes of bleeding

Diverticular bleeding

5 (11.6)

17 (25)

0.092

Ischemic colitis

2 (4.6)

6 (8.8)

0.478

Angiodysplasia

8 (18.6)

6 (8.8)

0.010

Polyps/neoplasia

13 (30.2)

8 (11.7)

0.025

Post-polypectomy

5 (11.6)

8 (11.7)

0.474

IBD

0 (0)

1 (1.4)

1.000

Ulcers

2 (4.6)

3 (4.4)

0.786

Colitis

3 (6.9)

4 (5.8 )

0.624

Hemorrhoids

2 (4.6)

2 (2.9 )

0.707

None

1 (2.3)

6 (8.8)

0.243

Others

0 (0)

1 (1.4)

1.000

**Table 3.** Clinical Outcome of Patients With ALGI Bleeding Taking Anticoagulants
	Non vitamin K oral anticoagulants (NOACs), N (%)	Warfarin, N (%)	P value
SD: standard deviation.
Presence of blood during endoscopy	18	30	0.845
Active bleeding during endoscopy	19	23	0.318
Need for endoscopic hemostasis	17 (39.5)	14 (20.5)	0.049
Need for transfusion	15	28	0.553
Blood transfusion (mean units ± SD)	1.7 ± 3.2	1.5 ± 2.2	0.700
Need for arterial embolization	1	0	1.000
Need for surgery	1	0	1.000
Hospitalization days ( ± SD)	4.5 ( ± 3.6)	6.1 (± 4.2)	0.032
Recurrence of bleeding	4 (9.3)	11 (16.1)	0.398
Mortality (%)	3 (6.9)	0 ( 0 )	0.056

Table 3. Clinical Outcome of Patients With ALGI Bleeding Taking Anticoagulants

Non vitamin K oral anticoagulants (NOACs), N (%)

Warfarin, N (%)

P value

SD: standard deviation.

Presence of blood during endoscopy

0.845

Active bleeding during endoscopy

0.318

Need for endoscopic hemostasis

17 (39.5)

14 (20.5)

0.049

Need for transfusion

0.553

Blood transfusion (mean units ± SD)

1.7 ± 3.2

1.5 ± 2.2

0.700

Need for arterial embolization

1.000

Need for surgery

1.000

Hospitalization days ( ± SD)

4.5 ( ± 3.6)

6.1 (± 4.2)

0.032

Recurrence of bleeding

4 (9.3)

11 (16.1)

0.398

Mortality (%)

3 (6.9)

0 ( 0 )

0.056