P4166 - Do Patients With Bleeding PUD on Blood Thinners Have Higher Severity of Bleeding and Rebleeding Risk?

Christina Joya, DO¹, John Ko, DO¹, Luis Rodriguez, DO¹, Simon Sabir, DO², Scott Diamond, DO¹, Elen Sarkisyan, DO¹, May Nguyen, DO², Jacob Everett, DO², Zaheer Siddiqui, DO¹, Vani Bhardwaj, DO², Aaron Levin Fay, DO², Meena Vemuri, ², Tyler Colunga, ², Sherli Koshy-Chenthittayil, PhD³, Vishvinder Sharma, MD^1
1Valley Hospital Medical Center, Las Vegas, NV; ²Touro University Nevada, Las Vegas, NV; ³Touro University Nevada, Henderson, NV

Introduction: Peptic ulcer disease (PUD) is an underlying etiology in 40-50% of cases of upper gastrointestinal bleeding (UGIB). Peptic ulcers occur when there are disruptions to the secretory, defense, or repair mechanisms of the mucosa resulting in mucosal damage. Blood thinners (anticoagulant and antiplatelet medications) have systemic and local effects that increase the likelihood of GI bleeding (associated relative risk of 10% for UGIBs). Whether these medications have an effect on the severity of UGIBs and rebleeding risk in patients with PUD has not been well documented.

Methods: A retrospective review was conducted on 1528 charts of patients that received an in-patient esophagogastroduodenoscopy (EGD) at Valley Hospital Medical Center from January 2016 to March 2023. Patients were included in the study (n=419) if they had symptoms of a GI bleed and underwent an EGD which confirmed a gastric or duodenal ulcer as the sole source of bleeding. The Forrest classification of the ulcer(s) and endoscopic interventions performed were obtained from chart review. Severity of the UGIB was determined by whether the patient required endoscopic bleeding therapy, IR embolization, or multiple EGDs within the same admission for their bleeding. Ulcers were categorized as high-risk or low-risk for rebleeding based on their Forrest classification.

Results: Of the 419 patients included in the study, 160 patients were on blood thinners and 259 patients were not on any blood thinners. Of the 160 patients on blood thinners, 54% had higher severity of bleeding. Of the 259 patients not on blood thinners, 48% had higher severity of bleeding. Chi-square tests revealed that the need for endoscopic bleeding therapy, IR embolization, and multiple EGDs was independent of whether the patient was on blood thinners (p-values > 0.05).



Of the 160 patients on blood thinners, 31% had high-risk ulcers (Forrest classification Ia, Ib, IIa, or IIb) and 69% had low-risk ulcers (Forrest classification IIc or III). Of the 259 patients not on blood thinners, 26% had high-risk ulcers and 74% had low-risk ulcers. A Fisher’s Exact test revealed that the Forrest classification was independent of whether the patient was on blood thinners (p-value > 0.05).

Discussion: Our study shows that blood thinner use does not affect the severity of upper GI bleeding and the risk of rebleeding in patients with PUD.



Disclosures:


Christina Joya, DO¹, John Ko, DO¹, Luis Rodriguez, DO¹, Simon Sabir, DO², Scott Diamond, DO¹, Elen Sarkisyan, DO¹, May Nguyen, DO², Jacob Everett, DO², Zaheer Siddiqui, DO¹, Vani Bhardwaj, DO², Aaron Levin Fay, DO², Meena Vemuri, ², Tyler Colunga, ², Sherli Koshy-Chenthittayil, PhD³, Vishvinder Sharma, MD¹. P4166 - Do Patients With Bleeding PUD on Blood Thinners Have Higher Severity of Bleeding and Rebleeding Risk?, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.