Clinical outcome of patients with obscure gastrointestinal bleeding during antithrombotic drug therapy

Yoshiyasu Kono, Seiji Kawano, Yuki Okamoto, Yuka Obayashi, Yuki Baba, Hiroyuki Sakae, Makoto Abe, Tatsuhiro Gotoda, Toshihiro Inokuchi, Hiromitsu Kanzaki, Masaya Iwamuro, Yoshiro Kawahara, Hiroyuki Okada

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: The clinical outcome of patients with obscure gastrointestinal bleeding (OGIB) during antithrombotic drug therapy has not been fully investigated. Methods: Patients who underwent video capsule endoscopy (VCE) for the investigation of OGIB at Okayama University Hospital from January 2009 to March 2016 were enrolled. We evaluated the VCE findings, the patterns of OGIB, and the rate of rebleeding within 1 year in antithrombotic drug users and antithrombotic drug nonusers. Results: A total of 181 patients were enrolled. Among the antithrombotic drug users, the rate of VCE positivity in the patients with overt OGIB was significantly higher in comparison with patients with occult OGIB (45% versus 16%, p = 0.014), whereas there was no significant difference among the antithrombotic drug nonusers (27% versus 26%, p = 1.0). Among the antithrombotic drug users, the rate of rebleeding among the VCE-positive patients was significantly higher in comparison with the VCE-negative patients (50% versus 5.9%, p = 0.011). Moreover, among antithrombotic drug users who did not receive therapeutic intervention, the rate of rebleeding among the VCE-positive patients was significantly higher in comparison with the VCE-negative patients (75% versus 6.3%, p = 0.001). However, among the antithrombotic drug nonusers who did not receive therapeutic intervention, the rebleeding rate of the VCE-positive patients was not significantly different from that of the VCE-negative patients (20% versus 9.4%, p = 0.43). Conclusion: Therapeutic intervention should be considered for patients with overt OGIB who are VCE positive and who use antithrombotic drugs due to the high risk of rebleeding.

Original languageEnglish
JournalTherapeutic Advances in Gastroenterology
Volume11
DOIs
Publication statusPublished - Jan 1 2018

Fingerprint

Capsule Endoscopy
Hemorrhage
Drug Therapy
Drug Users
Pharmaceutical Preparations
Therapeutics

Keywords

  • Antithrombotic drug
  • Capsule endoscopy
  • Obscure gastrointestinal bleeding

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Clinical outcome of patients with obscure gastrointestinal bleeding during antithrombotic drug therapy. / Kono, Yoshiyasu; Kawano, Seiji; Okamoto, Yuki; Obayashi, Yuka; Baba, Yuki; Sakae, Hiroyuki; Abe, Makoto; Gotoda, Tatsuhiro; Inokuchi, Toshihiro; Kanzaki, Hiromitsu; Iwamuro, Masaya; Kawahara, Yoshiro; Okada, Hiroyuki.

In: Therapeutic Advances in Gastroenterology, Vol. 11, 01.01.2018.

Research output: Contribution to journalArticle

@article{32afd71bca5746e7bf595f283f530acd,
title = "Clinical outcome of patients with obscure gastrointestinal bleeding during antithrombotic drug therapy",
abstract = "Background: The clinical outcome of patients with obscure gastrointestinal bleeding (OGIB) during antithrombotic drug therapy has not been fully investigated. Methods: Patients who underwent video capsule endoscopy (VCE) for the investigation of OGIB at Okayama University Hospital from January 2009 to March 2016 were enrolled. We evaluated the VCE findings, the patterns of OGIB, and the rate of rebleeding within 1 year in antithrombotic drug users and antithrombotic drug nonusers. Results: A total of 181 patients were enrolled. Among the antithrombotic drug users, the rate of VCE positivity in the patients with overt OGIB was significantly higher in comparison with patients with occult OGIB (45{\%} versus 16{\%}, p = 0.014), whereas there was no significant difference among the antithrombotic drug nonusers (27{\%} versus 26{\%}, p = 1.0). Among the antithrombotic drug users, the rate of rebleeding among the VCE-positive patients was significantly higher in comparison with the VCE-negative patients (50{\%} versus 5.9{\%}, p = 0.011). Moreover, among antithrombotic drug users who did not receive therapeutic intervention, the rate of rebleeding among the VCE-positive patients was significantly higher in comparison with the VCE-negative patients (75{\%} versus 6.3{\%}, p = 0.001). However, among the antithrombotic drug nonusers who did not receive therapeutic intervention, the rebleeding rate of the VCE-positive patients was not significantly different from that of the VCE-negative patients (20{\%} versus 9.4{\%}, p = 0.43). Conclusion: Therapeutic intervention should be considered for patients with overt OGIB who are VCE positive and who use antithrombotic drugs due to the high risk of rebleeding.",
keywords = "Antithrombotic drug, Capsule endoscopy, Obscure gastrointestinal bleeding",
author = "Yoshiyasu Kono and Seiji Kawano and Yuki Okamoto and Yuka Obayashi and Yuki Baba and Hiroyuki Sakae and Makoto Abe and Tatsuhiro Gotoda and Toshihiro Inokuchi and Hiromitsu Kanzaki and Masaya Iwamuro and Yoshiro Kawahara and Hiroyuki Okada",
year = "2018",
month = "1",
day = "1",
doi = "10.1177/1756283X17746930",
language = "English",
volume = "11",
journal = "Therapeutic Advances in Gastroenterology",
issn = "1756-283X",
publisher = "SAGE Publications Ltd",

}

TY - JOUR

T1 - Clinical outcome of patients with obscure gastrointestinal bleeding during antithrombotic drug therapy

AU - Kono, Yoshiyasu

AU - Kawano, Seiji

AU - Okamoto, Yuki

AU - Obayashi, Yuka

AU - Baba, Yuki

AU - Sakae, Hiroyuki

AU - Abe, Makoto

AU - Gotoda, Tatsuhiro

AU - Inokuchi, Toshihiro

AU - Kanzaki, Hiromitsu

AU - Iwamuro, Masaya

AU - Kawahara, Yoshiro

AU - Okada, Hiroyuki

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: The clinical outcome of patients with obscure gastrointestinal bleeding (OGIB) during antithrombotic drug therapy has not been fully investigated. Methods: Patients who underwent video capsule endoscopy (VCE) for the investigation of OGIB at Okayama University Hospital from January 2009 to March 2016 were enrolled. We evaluated the VCE findings, the patterns of OGIB, and the rate of rebleeding within 1 year in antithrombotic drug users and antithrombotic drug nonusers. Results: A total of 181 patients were enrolled. Among the antithrombotic drug users, the rate of VCE positivity in the patients with overt OGIB was significantly higher in comparison with patients with occult OGIB (45% versus 16%, p = 0.014), whereas there was no significant difference among the antithrombotic drug nonusers (27% versus 26%, p = 1.0). Among the antithrombotic drug users, the rate of rebleeding among the VCE-positive patients was significantly higher in comparison with the VCE-negative patients (50% versus 5.9%, p = 0.011). Moreover, among antithrombotic drug users who did not receive therapeutic intervention, the rate of rebleeding among the VCE-positive patients was significantly higher in comparison with the VCE-negative patients (75% versus 6.3%, p = 0.001). However, among the antithrombotic drug nonusers who did not receive therapeutic intervention, the rebleeding rate of the VCE-positive patients was not significantly different from that of the VCE-negative patients (20% versus 9.4%, p = 0.43). Conclusion: Therapeutic intervention should be considered for patients with overt OGIB who are VCE positive and who use antithrombotic drugs due to the high risk of rebleeding.

AB - Background: The clinical outcome of patients with obscure gastrointestinal bleeding (OGIB) during antithrombotic drug therapy has not been fully investigated. Methods: Patients who underwent video capsule endoscopy (VCE) for the investigation of OGIB at Okayama University Hospital from January 2009 to March 2016 were enrolled. We evaluated the VCE findings, the patterns of OGIB, and the rate of rebleeding within 1 year in antithrombotic drug users and antithrombotic drug nonusers. Results: A total of 181 patients were enrolled. Among the antithrombotic drug users, the rate of VCE positivity in the patients with overt OGIB was significantly higher in comparison with patients with occult OGIB (45% versus 16%, p = 0.014), whereas there was no significant difference among the antithrombotic drug nonusers (27% versus 26%, p = 1.0). Among the antithrombotic drug users, the rate of rebleeding among the VCE-positive patients was significantly higher in comparison with the VCE-negative patients (50% versus 5.9%, p = 0.011). Moreover, among antithrombotic drug users who did not receive therapeutic intervention, the rate of rebleeding among the VCE-positive patients was significantly higher in comparison with the VCE-negative patients (75% versus 6.3%, p = 0.001). However, among the antithrombotic drug nonusers who did not receive therapeutic intervention, the rebleeding rate of the VCE-positive patients was not significantly different from that of the VCE-negative patients (20% versus 9.4%, p = 0.43). Conclusion: Therapeutic intervention should be considered for patients with overt OGIB who are VCE positive and who use antithrombotic drugs due to the high risk of rebleeding.

KW - Antithrombotic drug

KW - Capsule endoscopy

KW - Obscure gastrointestinal bleeding

UR - http://www.scopus.com/inward/record.url?scp=85041391379&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85041391379&partnerID=8YFLogxK

U2 - 10.1177/1756283X17746930

DO - 10.1177/1756283X17746930

M3 - Article

AN - SCOPUS:85041391379

VL - 11

JO - Therapeutic Advances in Gastroenterology

JF - Therapeutic Advances in Gastroenterology

SN - 1756-283X

ER -