Improved outcomes in patients with non-variceal upper gastrointestinal bleeding while undergoing antithrombotic therapy: A propensity score matching analysis


Acehan F., Karsavuranoğlu B., Aslan M., Kalkan Ç., Sahiner E. S., Inan O., ...More

Digestive and Liver Disease, vol.56, no.11, pp.1854-1862, 2024 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 56 Issue: 11
  • Publication Date: 2024
  • Doi Number: 10.1016/j.dld.2024.04.038
  • Journal Name: Digestive and Liver Disease
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE, MEDLINE
  • Page Numbers: pp.1854-1862
  • Keywords: Antiplatelets, Antithrombotics, Non-variceal upper gastrointestinal bleeding, Propensity score
  • Gazi University Affiliated: No

Abstract

Background: This study sought to examine the effect of antithrombotic use on clinical outcomes in non-variceal upper gastrointestinal bleeding (UGIB). Methods: Patients consecutively diagnosed with non-variceal UGIB between February 2019 and September 2020 were divided into two groups based on their antithrombotic use: users and non-users. Using propensity score matching (PSM) and multivariable regression analyses, the impact of antithrombotic use prior to UGIB presentation on clinical outcomes was examined. Results: In the entire cohort, there were 210 and 260 patients in the antithrombotic user and non-user groups, respectively. Using PSM analysis with seven covariates, two matched groups of 157 patients were created at a 1:1 ratio. In the matched cohort, despite their longer hospital stays and a higher rate of intensive care unit admissions, the patients in the user group had lower 30- and 90-day mortality rates (4.5% vs. 14.0 %; p = 0.003 and 8.9% vs. 18.5 %; p = 0.014, respectively). In the entire cohort, multivariable analyses adjusted for confounding factors revealed that antithrombotic use was associated with lower risks of in-hospital (adjusted OR: 0.437; 95 % CI: 0.191–0.999), 30-day (adjusted OR: 0.261; 95 % CI: 0.099–0.689), and 90-day (adjusted OR: 0.386; 95 % CI: 0.182–0.821) mortality. Conclusion: Antithrombotic use prior to UGIB presentation was found to be an independent protective factor for all-cause mortality.