Rebleeding vs Thromboembolism After Hospitalization for Gastrointestinal Bleeding in Patients on Direct Oral Anticoagulants

Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association
Neil SenguptaElliot B Tapper

Abstract

Little is known about outcomes of patients hospitalized for gastrointestinal bleeding (GIB) while they are taking direct oral anticoagulants (DOAC). We aimed to determine the frequency at which patients resume DOAC therapy following hospitalization for GIB in a real-world setting, and the risks and benefits. We conducted a retrospective analysis of medical claims data from the Truven Health Marketscan Commercial Claims and Encounters Database, from January 1, 2010, through December 31, 2014. We collected data on 1338 adults treated with DOACs and hospitalized for GIB (dabigatran, n = 679; rivaroxaban, n = 608, apixaban, n = 51). Patients who developed GIB within 1 year of DOAC initiation, and had a DOAC claim filled within 1 month of GIB, were included in the analysis. Postdischarge readmissions due to thromboembolism and recurrent GIB within 90 days were reviewed. We used proportional hazards to identify factors associated with thromboembolism and recurrent GIB. The median age of patients who did not resume DOAC therapy was older (79 vs 78 y for patients who did resume DOAC therapy; P = .0005). Higher proportions of patients who did not resume DOAC had heart failure (25% vs 20% who did resume DOAC therapy; P = .01), received b...Continue Reading

Citations

Jun 28, 2019·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Charlotte RosenHaim Arie Abenhaim
Jan 16, 2019·World Journal of Gastroenterology : WJG·Tomonori AokiKazuhiko Koike
Oct 9, 2020·Stroke; a Journal of Cerebral Circulation·Eric ZhouShadi Yaghi
Dec 10, 2020·European Journal of Hospital Pharmacy. Science and Practice·Jesus RuizMaría Antonia Mangues
Nov 24, 2020·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Natalie TapaskarNeil Sengupta
Jan 7, 2021·Digestive Diseases and Sciences·Truman J MillingNeil Sengupta
Apr 6, 2021·Therapeutic Advances in Gastroenterology·Steven DeitelzweigGregory Y H Lip
Jun 21, 2021·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Blake Jones
Jun 19, 2021·Cardiovascular Drugs and Therapy·Robert BenamouzigLaurent Fauchier

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