Effects of antiplatelet, anticoagulant, and nonsteroidal anti-inflammatory drugs on upper gastrointestinal bleeding in geriatric patients

In patients presenting with upper gastrointestinal bleeding (UGIB), it is crucial to assess the risk factors associated with poor clinical outcomes. The aim of this study is to evaluate the impact of antiplatelet, anticoagulant, and nonsteroidal anti-inflammatory drug (NSAID) usage on clinical outcomes in geriatric patients with UGIB. This study was conducted between January 2022 and December 2023, retrospectively. In total, 297 patients presenting with UGIB who were over 65 years of age were included in the study. Patients were divided into 4 groups based on their medication: antiplatelet, anticoagulant, NSAID groups, and no drug. The need for blood transfusion, need for endoscopic treatment, rebleeding rate, need for surgery or interventional radiology, length of hospital stay, and 30-day mortality rate were compared between the groups. In total, 103 (34.6%) patients were using antiplatelets, 83 (27.9%) patients were using anticoagulants, 32 (10.7%) patients were using NSAIDs, and 79 (26.5%) patients were using none of them. Hypertension, diabetus mellitus, cardiovascular and cerebrovascular diseases were more common in patients with antiplatelet and anticoagulant groups. On admission in the anticoagulant group, Glasgow-Blatchford score was found to be higher, systolic blood pressure and hemoglobin levels were found to be lower. However, there was no significant difference between the 4 groups in terms of 30-day mortality, rebleeding, number of blood transfusion or length of hospital stay (P > .05 for all parameters). NSAID or antithrombotic use was not associated with poor outcomes in geriatric patients with UGIB.