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Clinical outcome in upper gastrointestinal bleeding complicating low‐dose aspirin and antithrombotic drugs
Author(s) -
TAHA A. S.,
ANGERSON W. J.,
KNILLJONES R. P.,
BLATCHFORD O.
Publication year - 2006
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2006.03017.x
Subject(s) - medicine , antithrombotic , aspirin , etiology , gastrointestinal bleeding , gastroenterology
Summary Background The current risk stratification systems in upper gastrointestinal bleeding do not correct for the intake of low‐dose aspirin and other antithrombotic drugs. Aim To test the Blatchford scores in evaluating the clinical outcome in bleeders using these drugs. Methods We calculated the Blatchford scores in 510 bleeders, including 123 on low‐dose aspirin, 44 on other antithrombotic drugs, and 68 on non‐steroidal anti‐inflammatory drugs. Results The median clinical scores distributed according to aetiological risk factors were as follows: no risk factors, 5; non‐steroidal anti‐inflammatory drugs, 8; aspirin, 7; other antithrombotics, 6; excess alcohol, 4; multiple risk factors, 7; ( P = 0.003, Kruskal–Wallis test). Scores correlated positively with the duration of admission in the entire group ( r s = 0.285; P < 0.001) and in those taking aspirin and antithrombotics ( r s = 0.211; P = 0.029). The median scores in patients requiring the blood transfusion were 10 in the entire group and 11 in users of aspirin or antithrombotics, compared with 3 and 4, respectively, in those not transfused ( P < 0.001). Conclusions The Blatchford scores are significantly elevated in users of non‐steroidal anti‐inflammatory drugs, low‐dose aspirin, and other antithrombotic drugs. They correlate positively with the duration of admission and the need for blood transfusion.