P4182 - Do Blood Thinners Affect Transfusion Requirements in Patients With Peptic Ulcer Disease?

Christina Joya, DO¹, John Ko, DO¹, Scott Diamond, DO¹, Nicholas Ciurczack, DO¹, Spencer Klatt, MS², Sherli Koshy, PhD³, Keaton Maguire, DO¹, Arjun Ponduri, MD¹, Chris Pace, DO¹, Savannah Spataro, DO¹, Heya Abid, DO¹, Jeevin Sandhu, ², Brian Carlson, MD^1
1Valley Hospital Medical Center, Las Vegas, NV; ²Touro University Nevada, Las Vegas, NV; ³Touro University Nevada, Henderson, NV

Introduction: Antiplatelet and anticoagulant medications carry the risk of potentiating gastrointestinal (GI) bleeding from areas with luminal lesions or insults. The local and systemic mechanisms by which they contribute to GI bleeding varies by class, including alterations in mucosal healing and direct topical anticoagulant effects. The comparative bleeding risk amongst these agents and predictive factors for major antiplatelet/anticoagulant associated GI bleeding have been well documented. There is limited data regarding specific clinical implications, including packed red blood cell (pRBC) transfusion requirements, in subsets of patients with GI bleeds on antiplatelets or anticoagulants with peptic ulcer disease (PUD).

Methods: A retrospective review was conducted on 1528 charts of patients that received an esophagogastroduodenoscopy (EGD) at Valley Hospital Medical Center in Las Vegas, Nevada from January 2016 to March 2023. Patients included in the study (n=419) had overt GI bleeding symptoms (melena, hematemesis, rectal bleeding), and received an inpatient, non-aborted EGD with endoscopically confirmed gastric or duodenal ulcers as the sole etiology for the GI bleed. Clinical information was obtained including patient antiplatelet or anticoagulant use, class of antiplatelet or anticoagulant if used, and the number of pRBC units transfusion during that hospital stay.

Results: Of the 419 patients in this study, 262 of the patients were not on any antiplatelet/anticoagulant, 67 patients were on aspirin monotherapy, 26 were on dual antiplatelet therapy, 5 were on antiplatelet monotherapy, 24 were on anticoagulant monotherapy, 24 were on anticoagulant and aspirin, 5 patients were on anticoagulant and antiplatelet excluding aspirin, and 6 patients were on an anticoagulant, antiplatelet, and aspirin. A multinomial regression study was performed and showed that the number of pRBC transfusion units was independent of whether the patient was on an antiaggregant or anticoagulant medication or combination (p-value >0.05).

Discussion: Our study has shown antiplatelet and anticoagulant use does not necessitate higher blood transfusion volumes in patients with upper gastrointestinal bleeding from PUD as compared to patients that were not taking these medications. There is no one particular anticoagulant, antiplatelet, or antiplatelet/anticoagulant combination that is shown to require increased transfusions in this patient population.



Disclosures:


Christina Joya, DO¹, John Ko, DO¹, Scott Diamond, DO¹, Nicholas Ciurczack, DO¹, Spencer Klatt, MS², Sherli Koshy, PhD³, Keaton Maguire, DO¹, Arjun Ponduri, MD¹, Chris Pace, DO¹, Savannah Spataro, DO¹, Heya Abid, DO¹, Jeevin Sandhu, ², Brian Carlson, MD¹. P4182 - Do Blood Thinners Affect Transfusion Requirements in Patients With Peptic Ulcer Disease?, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.