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Gross lower gastrointestinal bleeding in patients on anticoagulant and-or antiplatelet therapy: Endoscopic findings, management, and clinical outcomes

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dc.contributor.author Hashash J.G.
dc.contributor.author Shamseddeen W.
dc.contributor.author Skoury A.
dc.contributor.author Aoun N.
dc.contributor.author Barada K.
dc.contributor.editor
dc.date Jan-2009
dc.date.accessioned 2017-10-05T15:39:26Z
dc.date.available 2017-10-05T15:39:26Z
dc.date.issued 2009
dc.identifier 10.1097/MCG.0b013e318151f9d7
dc.identifier.isbn
dc.identifier.issn 01920790
dc.identifier.uri http://hdl.handle.net/10938/16866
dc.description.abstract OBJECTIVES: Gross gastrointestinal (GI) bleeding is a serious complication of anticoagulant-antiplatelet drug therapy. This study compares the frequencies of colorectal pathologies, endoscopic and resuscitative management measures, and clinical outcomes of patients hospitalized with lower GI bleeding (LGIB) while using anticoagulants-antiplatelets with those of patients not using them. METHODS: A retrospective review of the records of 166 admissions for patients with gross LGIB over 12 years was conducted. The colonoscopic findings, management measures, and clinical outcomes were compared between 2 groups. Group A composed of 100 patients using any antiplatelet-anticoagulant, and group B 66 patients not using any such drugs. Independent t tests and χ were used to test for association between taking antiplatelet-anticoagulant and other variables. RESULTS: Patients in group A were older and had more comorbidities than patients in group B. Severe LGIB occurred in 55.1percent and 35.4percent in groups A and B, respectively (P=0.01). Severity was not related to old age or the presence of comorbidities. A higher percentage of patients in group A had a hospital stay ≥6 days (44percent vs. 27.3percent; P0.03), required blood transfusions (68percent vs. 51.5percent; P=0.03), and had in-hospital complications (37percent vs. 22.7percent; P=0.052). The most common source of bleeding was diverticulosis in both groups. Colorectal abnormalities were present in most patients; and in those using warfarin, colon cancer was common. CONCLUSIONS: Use of antiplatelets- anticoagulant drugs is an independent predictor of severe LGIB and is associated with adverse outcomes. Colonoscopy is required in patients who bleed while using such drugs. © 2009 Lippincott Williams and Wilkins, Inc.
dc.format.extent
dc.format.extent Pages: (36-42)
dc.language English
dc.relation.ispartof Publication Name: Journal of Clinical Gastroenterology; Publication Year: 2009; Volume: 43; no. 1; Pages: (36-42);
dc.relation.ispartofseries
dc.relation.uri
dc.source Scopus
dc.subject.other
dc.title Gross lower gastrointestinal bleeding in patients on anticoagulant and-or antiplatelet therapy: Endoscopic findings, management, and clinical outcomes
dc.type Article
dc.contributor.affiliation Hashash, J.G., Department of Internal Medicine, Gastroenterology Division, American University of Beirut Medical Center, PO Box 11-0236, Beirut 1107 2020, Lebanon
dc.contributor.affiliation Shamseddeen, W., Department of Internal Medicine, Gastroenterology Division, American University of Beirut Medical Center, PO Box 11-0236, Beirut 1107 2020, Lebanon
dc.contributor.affiliation Skoury, A., Department of Internal Medicine, Gastroenterology Division, American University of Beirut Medical Center, PO Box 11-0236, Beirut 1107 2020, Lebanon
dc.contributor.affiliation Aoun, N., Department of Internal Medicine, Gastroenterology Division, American University of Beirut Medical Center, PO Box 11-0236, Beirut 1107 2020, Lebanon
dc.contributor.affiliation Barada, K., Department of Internal Medicine, Gastroenterology Division, American University of Beirut Medical Center, PO Box 11-0236, Beirut 1107 2020, Lebanon
dc.contributor.authorAddress Barada, K.; Department of Internal Medicine, Gastroenterology Division, American University of Beirut Medical Center, PO Box 11-0236, Beirut 1107 2020, Lebanon; email: kb02@aub.edu.lb
dc.contributor.authorCorporate University: American University of Beirut Medical Center; Faculty: Faculty of Medicine; Department: Internal Medicine; Division: Gastroenterology and Hepatology;
dc.contributor.authorDepartment Internal Medicine
dc.contributor.authorDivision Gastroenterology and Hepatology
dc.contributor.authorEmail
dc.contributor.authorFaculty Faculty of Medicine
dc.contributor.authorInitials
dc.contributor.authorOrcidID
dc.contributor.authorReprintAddress
dc.contributor.authorResearcherID
dc.contributor.authorUniversity American University of Beirut Medical Center
dc.description.cited
dc.description.citedCount 9
dc.description.citedTotWOSCount
dc.description.citedWOSCount
dc.format.extentCount 7
dc.identifier.articleNo
dc.identifier.coden JCGAD
dc.identifier.pubmedID 18698263
dc.identifier.scopusID 67651154293
dc.identifier.url
dc.publisher.address
dc.relation.ispartofConference
dc.relation.ispartofConferenceCode
dc.relation.ispartofConferenceDate
dc.relation.ispartofConferenceHosting
dc.relation.ispartofConferenceLoc
dc.relation.ispartofConferenceSponsor
dc.relation.ispartofConferenceTitle
dc.relation.ispartofFundingAgency
dc.relation.ispartOfISOAbbr
dc.relation.ispartOfIssue 1
dc.relation.ispartOfPart
dc.relation.ispartofPubTitle Journal of Clinical Gastroenterology
dc.relation.ispartofPubTitleAbbr J. Clin. Gastroenterol.
dc.relation.ispartOfSpecialIssue
dc.relation.ispartOfSuppl
dc.relation.ispartOfVolume 43
dc.source.ID
dc.type.publication Journal
dc.subject.otherAuthKeyword Anticoagulation
dc.subject.otherAuthKeyword Antiplatelet
dc.subject.otherAuthKeyword Gastrointestinal bleeding
dc.subject.otherChemCAS acetylsalicylic acid, 493-53-8, 50-78-2, 53663-74-4, 53664-49-6, 63781-77-1
dc.subject.otherChemCAS clopidogrel, 113665-84-2, 120202-66-6, 90055-48-4, 94188-84-8
dc.subject.otherChemCAS vitamin K group, 12001-79-5
dc.subject.otherChemCAS warfarin, 129-06-6, 2610-86-8, 3324-63-8, 5543-58-8, 81-81-2
dc.subject.otherChemCAS Anticoagulants
dc.subject.otherChemCAS Platelet Aggregation Inhibitors
dc.subject.otherIndex acetylsalicylic acid
dc.subject.otherIndex anticoagulant agent
dc.subject.otherIndex antithrombocytic agent
dc.subject.otherIndex clopidogrel
dc.subject.otherIndex fresh frozen plasma
dc.subject.otherIndex low molecular weight heparin
dc.subject.otherIndex vitamin K group
dc.subject.otherIndex warfarin
dc.subject.otherIndex aged
dc.subject.otherIndex article
dc.subject.otherIndex blood transfusion
dc.subject.otherIndex cerebrovascular accident
dc.subject.otherIndex clinical feature
dc.subject.otherIndex colon cancer
dc.subject.otherIndex colonoscopy
dc.subject.otherIndex comorbidity
dc.subject.otherIndex controlled study
dc.subject.otherIndex coronary artery disease
dc.subject.otherIndex deep vein thrombosis
dc.subject.otherIndex disease severity
dc.subject.otherIndex diverticulosis
dc.subject.otherIndex female
dc.subject.otherIndex gastrointestinal endoscopy
dc.subject.otherIndex gastrointestinal hemorrhage
dc.subject.otherIndex heart atrium fibrillation
dc.subject.otherIndex histopathology
dc.subject.otherIndex hospitalization
dc.subject.otherIndex human
dc.subject.otherIndex hypercoagulability
dc.subject.otherIndex lung embolism
dc.subject.otherIndex major clinical study
dc.subject.otherIndex male
dc.subject.otherIndex medical record review
dc.subject.otherIndex outcome assessment
dc.subject.otherIndex priority journal
dc.subject.otherIndex resuscitation
dc.subject.otherIndex Adult
dc.subject.otherIndex Age Factors
dc.subject.otherIndex Aged
dc.subject.otherIndex Aged, 80 and over
dc.subject.otherIndex Anticoagulants
dc.subject.otherIndex Colonoscopy
dc.subject.otherIndex Comorbidity
dc.subject.otherIndex Diverticulum
dc.subject.otherIndex Female
dc.subject.otherIndex Gastrointestinal Hemorrhage
dc.subject.otherIndex Humans
dc.subject.otherIndex Intestine, Large
dc.subject.otherIndex Length of Stay
dc.subject.otherIndex Male
dc.subject.otherIndex Middle Aged
dc.subject.otherIndex Platelet Aggregation Inhibitors
dc.subject.otherIndex Retrospective Studies
dc.subject.otherIndex Risk Factors
dc.subject.otherIndex Severity of Illness Index
dc.subject.otherKeywordPlus
dc.subject.otherWOS


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