New oral anti̇coagulant use frequency and prognosti̇c effect i̇n pati̇ents presenti̇ng wi̇th gastroi̇ntesti̇nal bleedi̇ng
2018
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Danışman: Prof. Dr. Sedef Kuran
Özet (EN)
New Oral Anticoagulant Use Frequency And Prognostic Effect In Patients Presenting With Gastrointestinal Bleeding Introduction: Oral anticoagulants are frequently used in the treatment of deep vein thrombosis/pulmonary embolism and in the prevention of venous thromboembolism in patients with atrial fibrillation or mechanical heart valve replacement. In addition to warfarin, the use of new oral anticoagulant drugs is becoming more common. Using Anticoagulant drugs is a risk factor for gastrointestinal bleeding and also increases bleeding. Our study aimed to evaluate the frequency of anticoagulant usage and its effect on prognosis in patients admitted with gastrointestinal bleeding. Materials and Method: Patients who developed gastrointestinal bleeding during admission between the dates of 12/05/2016 and 05/09/2017 to the Balcalı Hospital of the Cukurova University Medical Faculty were prospectively included to the study. Patients were classified as those who used new oral anticoagulants and those who did not use new oral anticoagulants and were compared for the following criteria age, pulse rate, presence of tachycardia, systolic blood pressure value, presence of systolic blood pressure below 100 mmHg, hospitalization duration (days), need for intensive care, duration in intensive care unit (days), hemoglobin decline (g/dl), the number of erythrocyte suspension transfusions (units), need for transfusion of erythrocyte suspension over 4 units . Patients using new oral anticoagulants were also compared for the same criteria with patients using warfarin and acetyl salicylic acid. Results: 146 patients were included into the study. 8 of the patients (5,5%) were using new oral anticoagulants with an average age of 82,2±7,7. When compared with patients who were not using new oral anticoagulants, patients who were using new oral anticoagulants were older and this was found to be statistically significant (p<0,001). Patients using new oral anticoagulants were older when compared to patients using warfarin and acetyl salicylic acid and this was found to be statistically significant (p:0,035 and 0,006). There were no statistical difference when patients using new oral anticoagulants were compared with those not using new oral anticoagulants in terms of pulse rate, presence of tachycardia, systolic blood pressure value, presence of systolic blood pressure below 100 mmHg, hospitalization duration (days), need for intensive care, duration in intensive care (days), hemoglobin decline (g/dl), the number of erythrocyte suspension transfusions (units), need for transfusion of erythrocyte suspension over 4 units (P>0,05). Mortality due to gastrointestinal bleeding in patients using new oral anticoagulants was not observed. Conclusion: There are a limited number of studies evaluating the frequency of use of new oral anticoagulants in patients with gastrointestinal bleeding. The frequency of use of new oral anticoagulants in patients admitted with gastrointestinal bleeding was 5.5% in our study. When patients using new oral anticoagulants were compared with patients who did not use new oral anticoagulants, and also compared separately with patients using warfarin and acetyl salicylic acid, we found that it did not adversely affect the prognosis. Due to the low number of patients using new oral anticoagulants, studies involving a greater number of patients are needed to obtain more accurate data on prognosis. Key Words: Gastrointestinal bleeding, new oral anticoagulants, warfarin
Yazar
Yalçın Bozkurt
Bu Yayına Nasıl Atıf Yapılır
Yalçın Bozkurt (Medical Specialty Thesis). New oral anti̇coagulant use frequency and prognosti̇c effect i̇n pati̇ents presenti̇ng wi̇th gastroi̇ntesti̇nal bleedi̇ng, 2018, Çukurova University.
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