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

Figure

Figure 1.
Figure 1. Percent of patients with ALGIB taking warfarin or NOACs per year.

Tables

Table 1. Type of Anticoagulation Therapy of Patients
 
N%
NOACs: non vitamin K oral anticoagulants.
Warfarin68/58711.6
NOACs43/5877.3
  Dabigatran233.9
  Apixaban30.5
  Rivaroxaban172.9

 

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 ALGIB43/587 (7.3)68/587 (11.6)
Age (mean ± SD)75.9 ± 9.577.1 ± 7.90.500
Male sex26390.844
History of prior GI bleeding591.000
Indication for anticoagulation
  Atrial fibrillation3750
  PE/DVT35
  Prosthetic valve313
Additional comorbidities39550.187
Mean Charlson comorbidity index5.15.40.948
Laboratory tests on admission
  Hb (mean ± SD)(mg/dL)10.5 ± 3.010.7 ± 2.60.835
  PLT (mean ± SD) (K/µL)215,387 ± 92,923199,387 ± 78,8900.388
  BUN (mean ± SD)(mg/dL)55.3 ± 27.858.7 ± 42.10.690
  Cr (median ± SD)(mg/dL)1.25 ± 0.381.1 ± 0.520.278
Small bowel bleeding (%)2/43 (4.6)6 (8.8)0.481
Causes of bleeding
  Diverticular bleeding5 (11.6)17 (25)0.092
  Ischemic colitis2 (4.6)6 (8.8)0.478
  Angiodysplasia8 (18.6)6 (8.8)0.010
  Polyps/neoplasia13 (30.2)8 (11.7)0.025
  Post-polypectomy5 (11.6)8 (11.7)0.474
  IBD0 (0)1 (1.4)1.000
  Ulcers2 (4.6)3 (4.4)0.786
  Colitis3 (6.9)4 (5.8 )0.624
  Hemorrhoids2 (4.6)2 (2.9 )0.707
  None1 (2.3)6 (8.8)0.243
  Others0 (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 endoscopy18300.845
Active bleeding during endoscopy19230.318
Need for endoscopic hemostasis17 (39.5)14 (20.5)0.049
Need for transfusion15280.553
Blood transfusion (mean units ± SD)1.7 ± 3.21.5 ± 2.20.700
Need for arterial embolization101.000
Need for surgery101.000
Hospitalization days ( ± SD)4.5 ( ± 3.6)6.1 (± 4.2)0.032
Recurrence of bleeding4 (9.3)11 (16.1)0.398
Mortality (%)3 (6.9)0 ( 0 )0.056