Dorotea Božić, Fausta Vrančića 13, 21000 Split, Croatia,
Croat Med J. 2021 Oct 31;62(5):488-494. doi: 10.3325/cmj.2021.62.488.
To investigate the demographic characteristics, endoscopic and laboratory findings, comorbidities and mortality rate of patients with gastrointestinal bleeding related to anticoagulant or antiplatelet therapy.
We reviewed the records of patients admitted for gastrointestinal bleeding to the Intensive Care Unit of the Department of Gastroenterology, University Hospital Split, between 2015 and 2019. The characteristics and clinical outcomes of patients taking anticoagulant/antiplatelet therapy were analyzed.
The study enrolled 1367 patients, 434 (31.7%) of whom received anticoagulant/antiplatelet therapy (mean age 74.9±10.7 years; 64.3% men). The most frequently prescribed drug was acetylsalicylic acid (56.7%), the most common bleeding site was the stomach (41.3%), and the most prevalent cause of bleeding was ulcer (61.6%). Patients taking anticoagulant/antiplatelet therapy who died had significantly higher creatinine (P=0.011) and lower albumin (P=0.015). In the multivariate analysis, the factors that negatively affected survival were older age, higher creatinine, and lower albumin. Patients taking anticoagulant/antiplatelet therapy had slightly lower in-hospital mortality (8.3%) compared with other patients (10.3%).
Although anticoagulant/antiplatelet therapy increases the risk of gastrointestinal bleeding, it does not directly affect the outcome, which is mainly determined by age and comorbidities.
研究与抗凝或抗血小板治疗相关的胃肠道出血患者的人口统计学特征、内镜和实验室检查结果、合并症和死亡率。
我们回顾了 2015 年至 2019 年间在斯普利特大学校医院消化内科重症监护病房因胃肠道出血住院的患者的记录。分析了接受抗凝/抗血小板治疗患者的特征和临床结局。
该研究纳入了 1367 名患者，其中 434 名（31.7%）接受了抗凝/抗血小板治疗（平均年龄 74.9±10.7 岁；64.3%为男性）。最常开的药物是乙酰水杨酸（56.7%），最常见的出血部位是胃（41.3%），最常见的出血原因是溃疡（61.6%）。接受抗凝/抗血小板治疗且死亡的患者的肌酐明显更高（P=0.011），白蛋白明显更低（P=0.015）。多因素分析显示，年龄较大、肌酐较高和白蛋白较低是影响生存的负面因素。与其他患者（10.3%）相比，接受抗凝/抗血小板治疗的患者的院内死亡率略低（8.3%）。
尽管抗凝/抗血小板治疗会增加胃肠道出血的风险，但它不会直接影响预后，预后主要由年龄和合并症决定。
