Farmacia hospitalaria : organo oficial de expresion cientifica de la Sociedad Espanola de Farmacia Hospitalaria · 2026
Risk factors for emergency department revisit among elderly patients with gastrointestinal bleeding secondary to oral anticoagulant therapy.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Garrido Quintero Andrea, Cercas Lobo Silvia, Ruiz Ramos Jesus, Plaza Díaz Adrián, González Díez Ane, Cañón Santos Antonio, Villarejo Jiménez Ana, Pérez Méndez María Carmenza, Puig Campmany Mireia
Аннотация
BACKGROUND: Gastrointestinal bleeding is a frequent cause of emergency department visits among anticoagulated patients. Antidepressants may potentiate bleeding risk by impairing platelet aggregation. The impact of concomitant antidepressant use on emergency room re-visits for gastrointestinal bleeding in anticoagulated elderly patients remains unclear.
OBJECTIVE: This study aimed to assess the risk factors for Emergency Department (ED) re-visit within 90 days after an initial bleeding episode in elderly patients on oral anticoagulant (OAC) therapy.
METHODS: A retrospective observational study was conducted at a hospital in Catalonia, including patients over 65 years treated with OACs who presented to the ED for gastrointestinal bleeding between 2018 and 2024. Data were obtained from electronic health records, including comorbidities, chronic medications, and discharge treatments. The primary outcome was ED revisit for bleeding within 90 days. Multivariate logistic regression was used to identify independent predictors.
RESULTS: Of 143 patients included [mean age 82.4 years; 51.7% women], 26.7% were on antidepressants, 8.3% on antiplatelet agents, and 77.6% on proton pump inhibitors. Over a mean follow-up of 90 days, 23,1% patients re-visited the emergency room with bleeding. Univariate analysis identified chronic kidney disease, antidepressant therapy, and antiplatelet use as significant factors. In multivariate models, independent predictors were chronic kidney disease (OR 2.50; 95% CI 1.07-5.85; p = 0.034), antidepressant use (OR 2.56; 95% CI 1.07-6.14; p = 0.034), and concomitant antiplatelet therapy (OR 4.55; 95% CI 1.27-16.28; p = 0.020).
CONCLUSIONS: In elderly patients anticoagulated, the addition of antidepressants significantly increases the risk of ED re-visit for gastrointestinal bleeding within 90 days. Chronic kidney disease and concomitant antiplatelet therapy also emerge as key risk factors.
OBJECTIVE: This study aimed to assess the risk factors for Emergency Department (ED) re-visit within 90 days after an initial bleeding episode in elderly patients on oral anticoagulant (OAC) therapy.
METHODS: A retrospective observational study was conducted at a hospital in Catalonia, including patients over 65 years treated with OACs who presented to the ED for gastrointestinal bleeding between 2018 and 2024. Data were obtained from electronic health records, including comorbidities, chronic medications, and discharge treatments. The primary outcome was ED revisit for bleeding within 90 days. Multivariate logistic regression was used to identify independent predictors.
RESULTS: Of 143 patients included [mean age 82.4 years; 51.7% women], 26.7% were on antidepressants, 8.3% on antiplatelet agents, and 77.6% on proton pump inhibitors. Over a mean follow-up of 90 days, 23,1% patients re-visited the emergency room with bleeding. Univariate analysis identified chronic kidney disease, antidepressant therapy, and antiplatelet use as significant factors. In multivariate models, independent predictors were chronic kidney disease (OR 2.50; 95% CI 1.07-5.85; p = 0.034), antidepressant use (OR 2.56; 95% CI 1.07-6.14; p = 0.034), and concomitant antiplatelet therapy (OR 4.55; 95% CI 1.27-16.28; p = 0.020).
CONCLUSIONS: In elderly patients anticoagulated, the addition of antidepressants significantly increases the risk of ED re-visit for gastrointestinal bleeding within 90 days. Chronic kidney disease and concomitant antiplatelet therapy also emerge as key risk factors.