Comparison of Short-term Outcomes in Anticoagulated Patients with GI Bleeding: Warfarin versus NOACs Antikoagülan Tedavi Gören Gastrointestinal Kanamalı Hastalarda Kısa Vadeli Sonuçların Karşılaştırılması: Warfarin ve NOAC’lar

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Sorgun O., Ocak N. Y.

Anatolian Journal of General Medical Research, cilt.35, sa.2, ss.223-229, 2025 (Scopus, TRDizin)

Özet

Objective: Gastrointestinal (GI) bleeding is a major complication of oral anticoagulant therapy. While non-vitamin K oral anticoagulants (NOACs) offer advantages over warfarin, limited real-world data exist comparing short-term clinical outcomes following GI bleeding events in anticoagulated patients. This study aims to compare clinical characteristics, intervention requirements, hospitalization outcomes, and mortality in patients presenting with GI bleeding while receiving warfarin or NOAC therapy, and to explore differences among individual NOAC agents. Methods: We conducted a single-center, retrospective, cross-sectional study including 299 adult patients who presented to the emergency department with GI bleeding while on oral anticoagulants. Data collected included demographics, laboratory values, interventions, and clinical outcomes. Subgroup analysis was performed among NOAC agents. Statistical comparisons used appropriate univariate tests; multivariable analysis was not feasible due to limited event counts. Results: Of 299 patients (mean age 75.8±10.4 years, 52.2% male), 30.1% were receiving warfarin and 69.9% NOACs. Emergency department mortality (2.0%) and in-hospital mortality (7.4%) were similar among the groups (p>0.05). Endoscopic interventions (75.3%) and erythrocyte transfusion needs (56.8%) did not differ significantly by anticoagulant type. Elevated creatinine was independently associated with in-hospital mortality (p=0.016). No significant differences in outcomes were found among individual NOAC agents. Conclusion: GI bleeding remains a serious but generally manageable event in patients on oral anticoagulants, with comparable short-term outcomes between warfarin and NOAC users. Renal dysfunction is an important predictor of mortality. Larger prospective studies are needed to refine risk stratification and optimize management in this population.