Management of Antithrombotic Agents During Emergency Endoscopy for Upper Gastrointestinal Bleeding: A Propensity Score Matching Analysis

Author:

Yamaguchi DaisukeORCID,Ishida Satoshi,Gondo Kasumi,Nomura Tadahiro,Yamaguchi Azuki,Asahi Ryosuke,Mizuta Yumi,Nagatsuma Goshi,Fukami Shota,Kimura Shunichiro,Fujimoto Shun,Shimakura Akane,Jubashi Amane,Takeuchi Yuki,Ikeda Kei,Tanaka Yuichiro,Yoshioka Wataru,Hino Naoyuki,Morisaki Tomohito,Ario Keisuke,Tsunada Seiji

Abstract

Background/Aims: This study is aimed at comparing the outcomes of upper gastrointestinal bleeding (UGIB) during emergency endoscopy between patients taking and not taking antithrombotic agents to inform antithrombotic management.Methods: We conducted a retrospective analysis of 389 patients who underwent emergency endoscopy for UGIB from 2016 to 2021. The patients were categorized into group A (taking antithrombotic agents) and group NA (not taking antithrombotic agents). The clinical characteristics, types of antithrombotic agents, patient status upon admission, and causes of UGIB were examined. Treatment outcomes and adverse events were assessed by propensity score matching (PSM).Results: Group A was significantly older and the primary antithrombotic agent was low‐dose aspirin, with multiple antithrombotics taken by 38 patients (29.0%). Peptic ulcers were the most common cause of UGIB in both groups. PSM generated 83 matched pairs. The success rate of endoscopic hemostasis in group A was significantly higher than in group NA (96.4% vs. 84.3%, P = 0.02). Despite promptly resuming antithrombotic agent posthemostasis, there was no significant difference in the rebleeding rate or 30‐day mortality.Conclusion: The high success rate of endoscopic hemostasis and no difference in adverse events made the prompt resumption of antithrombotic medications after emergency endoscopy for UGIB acceptable.Trial Registration: ClinicalTrials.gov identifier: UMIN000053561

Publisher

Wiley

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