Research Communication: The Risk and Outcomes of Gastrointestinal Bleeding in Patients Using Warfarin or Direct Oral Anticoagulants

Gastrointestinal bleeding (GIB) is a common medical emergency, with vitamin K antagonists (such as warfarin) and direct oral anticoagulants (DOACs) being important risk factors. We investigated the impact of anticoagulant medications on patient outcomes in upper and lower GIB. Using TriNetX, a global research database, we examined outcomes in patients with GIB with and without anticoagulant medications, propensity-matched based on age, sex, race and co-morbidities. Patients taking either DOACs or warfarin had more severe GIB and greater mortality than non-anticoagulated patients, even after controlling for comorbid status. Anticoagulated patients also had higher rates of delayed endoscopy.