The role of anticoagulants and antiplatelet agents in the etiology of non-variceal upper gastrointestinal system bleeding

Introduction and Objective: Non-variceal upper gastrointestinal system bleeding (UGIB) is a life-threatening condition. Numerous factors contribute to its etiology, with esophagogastroduodenoscopy (EGD) being considered the gold standard for diagnosis. Additionally, clinical scoring systems are utilized to predict morbidity and mortality. Studies in the literature indicate that the use of anticoagulant and antiplatelet drugs may increase the risk of gastrointestinal bleeding. In this study, we aimed to determine the frequency of the role of anticoagulant and antiplatelet drugs in the etiology of patients diagnosed with non-variceal UGIB in our clinic. Furthermore, we sought to investigate their relationship with the amount of red blood cell suspension transfusion, mortality, intensive care unit (ICU) admission, and gastrointestinal bleeding scores (Full Rockall Score, AIMS65 Score, Glasgow-Blatchford Score, and ABC Score) in bleeding patients. Materials and Methods: This study retrospectively evaluated the data of 174 adult patients diagnosed with non-variceal UGIB confirmed by the Gastroenterology Clinic of Bolu Abant İzzet Baysal University Training and Research Hospital. Patients over the age of 18 who underwent endoscopy within the first 72 hours and had a bleeding focus identified were included. In our study, 131 (75.3%) patients were using anticoagulant, antiplatelet, or nonsteroidal anti-inflammatory drugs (NSAIDs), while 43 (24.7%) patients were not using any of these medications. Results: In this study, 131 (75.3%) patients were using anticoagulant, antiplatelet, or NSAID medications, while 43 (24.7%) patients were not using any of these drugs. Drug use did not affect the amount of red blood cell suspension transfusion, ICU admission, mortality, or Glasgow-Blatchford Score. However, it led to significantly higher scores in the Full Rockall, AIMS65, and ABC scoring systems compared to the group not using any medications. Conclusion: The use of antiplatelet or anticoagulant medications resulted in significantly higher Full Rockall, AIMS65, and ABC scores in patients with UGIB compared to those not using these drugs. KEYWORDS: Upper Gastrointestinal System Bleeding, Anticoagulant, Antiplatelet, GIS Bleeding Risk Scores, Full Rockall, AIMS65, Glasgow-Blatchford, ABC Score