Turkish Journal of Gastroenterology
Original Article

Clinical Outcomes of Older Patients with Non-Variceal Upper Gastrointestinal Bleeding Taking Anti-Thrombotic or Non-Steroidal Anti-Inflammatory Agents

1.

Department of Gastroenterology, Ankara City Hospital, Ankara, Turkey

2.

Department of Gastroenterology, Health Sciences University, Mehmet Akif İnan Training and Research Hospital, Şanlıurfa, Turkey

3.

Graduate School of Health Sciences, Hacettepe University, Ankara, Turkey

4.

Department of Gastroenterology, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey

Turk J Gastroenterol 2023; 34: 918-924
DOI: 10.5152/tjg.2023.23226
Read: 837 Downloads: 375 Published: 17 August 2023

Background/Aims: Non-variceal upper gastrointestinal bleeding is a well-established complication of non-steroidal anti-inflammatory drugs and anti-thrombotics. Both medication groups are frequently used by older populations and increase the incidence of non-var- iceal upper gastrointestinal bleeding; however, their impact on etiology and outcomes of non-variceal upper gastrointestinal bleeding has not been well defined. We aimed to compare the etiology and outcomes of non-variceal upper gastrointestinal bleeding in older patients who use anti-thrombotics and non-steroidal anti-inflammatory drugs or do not use either of them.

Materials and Methods: This is a single-center prospective study of patients older than 65 years with non-variceal upper gastrointesti- nal bleeding. Endoscopic findings, laboratory values, blood transfusion, endoscopic treatment, re-bleeding, and 30-day mortality rates were recorded.

Results: A total of 257 patients (median age 77.7 ± 8.2, 59% male) were included. Re-bleeding occurred in 25 (10%) and the 30-day mortality rate was 40 (16%). There was no statistically significant difference between patients using anti-thrombotics, non-steroidal anti-inflammatory drugs or non-users for blood transfusion (P = .46), endoscopic hemostasis (P = .39), re-bleeding (P = .09), and 30-day mortality (P = .45). Peptic ulcer was the most common etiology in all groups (124, 48%). Although the incidence of peptic ulcer was similar between drug users and anti-thrombotic users (P = .75), the incidence of peptic ulcer was significantly higher in patients using non-steroidal anti-inflammatory drugs than in patients who did not use drugs (P = .05). When the patients were analyzed as using anti- thrombotic drugs or non-steroidal anti-inflammatory drugs or neither, no statistically significant difference was found between ulcer location, ulcer number, and ulcer size.

Conclusion: Non-variceal upper gastrointestinal bleeding increasingly occurs in older populations with several comorbidities; non- steroidal anti-inflammatory drugs or anti-thrombotics do not seem to change the clinical outcomes among older patients with non- variceal upper gastrointestinal bleeding.

Cite this article as: Durak MB, Şimşek C, Yüksel İ. Clinical outcomes of older patients with non-variceal upper gastrointestinal bleeding taking anti-thrombotic or non-steroidal anti-inflammatory agents. Turk J Gastroenterol. 2023;34(9):918-924.

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