Major gastrointestinal bleeding and antithrombotics: Characteristics and management

作     者：Jacques Bouget Damien Viglino Quentin Yvetot Emmanuel Oger 

作者机构：EA 7449 REPERESPharmacoepidemiology and Health Services ResearchUniv RennesRennes 35000France Emergency Department and Mobile Intensive Care Unit-HP2 Laboratory INSERM U1042University Grenoble AlpsLa Tronche 38700France Emergency DepartmentCHU RennesRennes 3500France EA 7449 REPERESUniversitéde Rennes 1Rennes 35000France 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2020年第26卷第36期

页      面：5463-5473页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：National Clinical Research Hospital Program of the French Ministry of Health No.PHRC-12-009-0243 

主　　题：Real-world setting Emergency Bleeding Mortality Antithrombotics Management 

摘      要：BACKGROUND There are few reports on major gastrointestinal(GI)bleeding among patients receiving an *** To describe clinical characteristics,bleeding locations,management and inhospital mortality related to these *** Over a three-year period,we prospectively identified 1080 consecutive adult patients admitted in two tertiary care hospitals between January 1,2013 and December 31,2015 for major GI bleeding while receiving an *** bleeding events were medically *** characteristics,causative lesions,management and fatalities were *** distribution of antithrombotics prescribed was compared across the bleeding lesions *** Of 576 patients had symptoms of upper GI bleeding and 504 symptoms of lower GI *** cause was identified for 383(35.5%)***-duodenal ulcer was the first causative lesion in the upper tract(209 out of 408)and colonic diverticulum the first causative lesion in the lower tract(120 out of 289).There was a larger proportion of direct oral anticoagulant use among patients with lower GI than among those with upper GI lesion locations(P=0.03).There was an independent association between gastro-duodenal ulcer and antithrombotic use(P=0.03),taking account of confounders and proton pump inhibitor *** wise comparisons pointed to a difference between vitamin K antagonist,direct oral anticoagulants,and antiplatelet agents in monotherapy vs dual antiplatelet *** We showed a higher rate of bleeding lesion identification and suggested a different pattern of antithrombotic exposure between upper and lower GI lesion locations and between gastro-duodenal ulcer and other identified upper GI causes of *** was similar across antithrombotics and in-hospital mortality was low(5.95%).