Comparison of the Effects of Warfarin and Direct Oral Anticoagulants in Upper Gastrointestinal System Bleeding

Background This study aimed to compare the frequency of use of new-generation oral anticoagulants or warfarin in patients presenting to our hospital with upper gastrointestinal system bleeding and to determine the rates of recurrent upper gastrointestinal system bleeding. Methods In this cross-sectional study, the data of 346 patients who applied to Samsun Research and Training Hospital between 01.01.2021 and 31.12.2021 and were hospitalized by Internal Medicine and Gastroenterology clinics with a diagnosis of upper gastrointestinal tract bleeding or who underwent outpatient endoscopy were examined retrospectively. Patients who experienced recurrent upper GI bleeding were identified. The frequency of direct oral anticoagulant drug usage in patients with recurrent bleeding was determined, and data such as rebleeding rate, length of hospital stay, transfusion requirement, and mortality were analyzed between the groups of patients who did not use the drug and those who did. Results Of 346 patients included in the study, 151 (43.6%) were female, 195 (56.4%) were male, and the mean age was 68.8±15.8 years. When the frequencies of drug usage that could create a risk of bleeding were examined, it was found that 107 (30.9%) used nonsteroidal anti-inflammatory drugs, 102 (29.5%) used acetylsalicylic acid, 65 (18.8%) used direct oral anticoagulants, 58 (16.8%) used clopidogrel, and 19 (5.5%) used warfarin. When the frequencies of drug usage that could create a risk of bleeding were compared according to recurrent bleeding and mortality status, it was found that the groups were statistically similar. Conclusion There was no difference in the frequency of recurrent upper gastrointestinal bleeding between the patients using warfarin and direct oral anticoagulants. When the patients were divided into two groups according to the incidence of recurrent gastrointestinal bleeding and compared in terms of age, gender, comorbid conditions that could cause bleeding, drug usage, and mortality, there was no statistically significant difference between the groups. More comprehensive studies are needed on this subject.