NEW ORAL ANTICOAGULANT USE ANDNON-VARICEAL UPPER GASTROINTESTINAL BLEEDING, A SINGLE CENTRE RETROSPECTIVE STUDY

Aims Use of new oral anticoagulants (NOAC) is becoming increasingly more common in our ageing co-morbid population. We reveiwed outcomes in patients admitted with non variceal upper GI bleeding (NVUGIB) over a 10 month period to assess their indication for use and if the use of NOACS or anti platelet agents correlated with UGIB outcomes

Methods Retrospective study analysing electronic endoscopy database from an academic teaching hospital from October 2018 to August 2019. All OGDs performed due to the indication of haematemesis and melaena were analysed. Patients were excluded if procedure was performed as an outpatient or if cause of bleed was deemed due to variceal bleeding. Clinical data and endoscopy reports were obtained from patient’s electronic health record.

Results 137 Inpatient upper GI endoscopies were performed for the indication of hematemesis and melaena (n = 17) haematemesis (n = 38), maleana (n = 62). 117 were due to non variceal bleeding. Of those, 26 (23.2%) patients were on NOAC, of which 11.7% (n = 10) were also on concomittent antiplatelet therapy. In our cohort, GBS correlated with number of RBC transfused (p < 0.001). NOAC use was associated with higher GBS score (p = 0.021) and higher Rockall score. There was no signficant assocation between GBS (p = 0.49), Rockall (p = 0.41) and number of RBC transfused (p = 0.26). No clear indication for NOAC and antiplatelet use was identified in 64 number of patients.

Conclusions The study further validates the use of GBS in clinical setting. Rationalisation of NOAC and concommitent antiplatelet use should be considered, where possible.