Aim: Acute gastrointestinal (GI) bleeding is one of the most common gastrointestinal causes of hospitalization. Several risk factors have been shown to contribute to the development of GI bleeding. The aim of this study was to determine the rate of use of new oral anticoagulants (NOACs), warfarin, and acetylsalicylic acid (ASA), and to evaluate the need for transfusion of erythrocyte suspension (ES), fresh frozen plasma (FFP), platelet suspension, and intensive care unit (ICU) outcomes in patients hospitalized in the intensive care unit due to acute non-variceal upper gastrointestinal bleeding.
Study Design: Patients admitted to the ICU for GI bleeding were divided into two groups: survivors and non-survivors. Demographic data, blood product transfusion needs, and prior antiplatelet and anticoagulant drug use were analyzed retrospectively. Differences between survivors and non-survivors were evaluated.
Materials and Methods: This single-center, retrospective observational study examined all antiaggregant and anticoagulant therapies used by patients admitted to the ICU for gastrointestinal bleeding between January 2019 and January 2023.
Results: Of the 397 patients included in the study, 59 (14.8%) died. The mean age of deceased patients was 75.5±11.9 years, and 25 (42.4%) were female. Anticoagulant or antiaggregant drugs were used by 165 (41.6%) of all patients and 39 (66.1%) of the patients who died. The most commonly used drugs were ASA (16.6%) and NOACs (12.8%). There were no differences between survivors and non-survivors in terms of gender (p=0.483), decrease in hemoglobin levels (p=0.087), or duration of intensive care unit stay (p=0.243). Additionally, no differences were observed in the transfusion of red blood cells (p=0.092) or platelet suspension (p=0.215) between survivors and non-survivors. The predictive factors for mortality were FFP transfusion (odds ratio [OR], 95% confidence interval [CI]: 0.253, [0.116-0.551], p<0.01), shorter ICU length of stay (OR: 1.127, 95% CI: [1.034-1.228], p<0.01), high pulse rate (OR: 0.970, [0.954-0.987], p<0.01), and lower systolic blood pressure (OR: 1.013, [1.00-1.026], p<0.04).
Conclusion: Despite the fact that FFP transfusion, shorter ICU stay, higher heart rate, and lower systolic blood pressure were strong predictors of mortality, no relationship was identified between ICU mortality and erythrocyte suspension (ES), thrombocyte transfusion, anticoagulant use or type, or hemoglobin level in patients admitted to the ICU with gastrointestinal bleeding.