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Warfarin use after LGIB-related hospitalization does not increase risk of mortality

02 Jul 2018

Resumption of warfarin at discharge following hospitalization for lower gastrointestinal bleeding (LGIB) is not associated with either 90-day or 6-month mortality, reports a study, adding that death in LGIB is primarily caused by age and comorbidities.

A total of 607 patients were admitted with warfarin-related LGIB, of which 403 (66.4 percent) had warfarin held at discharge. Univariate analysis showed an association between warfarin discontinuation and an increased 90-day and 6-month mortality (hazard ratio [HR], 2.07; 95 percent CI, 1.04–4.58; HR, 1.78; 1.02–3.27; p=0.04 for both).

Multivariate regression adjusted for age, comorbidities and transfusion requirement revealed that only a higher Charlson Index was associated with an increased 90-day mortality (HR, 1.18; 1.07–1.29; p<0.001) and older age with an increased 6-month mortality (HR, 1.02; 1.00–1.05; p=0.02), with no significantly increased mortality risk with holding warfarin (HR, 1.48; 0.84–2.78; p=0.18).

A previous study found that use of antithrombotic drugs and age ≥65 years increased the risk of bleeding recurrence and mortality among patients with LGIB. [Clin Gastroenterol Hepatol 2015;13:488-494.e1]

To determine whether warfarin resumption following LGIB-related hospitalization was associated with improved 90-day and 6-month survival, the authors used a validated, machine-learning algorithm to identify patients hospitalized for LGIB while on warfarin.

Participants were classified as those who had warfarin resumed at discharge and those did not. The authors used univariate and multivariate Cox proportional hazards to determine whether resuming warfarin correlated with improved 90-day and 6-month mortality.

“LGIB is a common complication for patients on warfarin,” the authors noted.

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Most Read Articles
17 Nov 2017
Total intravenous anaesthesia with propofol yields better survival compared with volatile anaesthetics (VA) for oesophageal cancer surgery, a recent retrospective observational study has found.
06 Sep 2018
Suicide appears to be more common in patients with cancers of the digestive system, especially in those with pancreatic and oesophageal cancers, a recent study has found.
08 Sep 2018
Use of statins may reduce the severity of acute pancreatitis (AP) seen in the decrease of overall incidence of multisystem organ failure (MSOF) and new MSOF, suggests a recent study.
12 Sep 2018
Hospitalization for acute biliary pancreatitis in elderly patients is likely to lead to adverse clinical outcomes, according to a study.