Risk factors for emergency department revisit in elderly patients with gastrointestinal bleeding secondary to anticoagulant therapy
| Autor: | Jesus Ruiz, Mireia Puig, Adrià Riera-Magallon, Ana Juanes, Maria Antonia Mangues, Laia López-Vinardell |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Gastrointestinal bleeding medicine.drug_class 030226 pharmacology & pharmacy 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine medicine Humans 030212 general & internal medicine General Pharmacology Toxicology and Pharmaceutics Aged First episode Geriatrics business.industry Anticoagulant Anticoagulants Atrial fibrillation Retrospective cohort study Emergency department medicine.disease humanities Stroke Emergency Service Hospital Gastrointestinal Hemorrhage business Kidney disease |
| Zdroj: | European Journal of Hospital Pharmacy. 29:271-274 |
| ISSN: | 2047-9964 2047-9956 |
| DOI: | 10.1136/ejhpharm-2020-002426 |
| Popis: | Objective To evaluate the frequency of emergency department (ED) revisits among elderly patients with gastrointestinal bleeding secondary to anticoagulant treatment and identify factors associated with an increased risk of ED revisits. Methods A 3-year retrospective observational study was designed, including elderly patients (≥65 years) with atrial fibrillation and undergoing oral anticoagulation therapy who visited the ED for gastrointestinal bleeding. To evaluate the risk factors for 30-day revisit, a multivariate analysis was designed including comorbidities, concomitant treatment, change in anticoagulant treatment and prescription of direct-acting oral anticoagulants. Results 80 patients were included. At discharge, anticoagulation therapy was modified in 21 (26.2%) patients; and changed from an oral anticoagulant to heparin in 17 (21.2%) patients and to another oral anticoagulant in 4 (5.0%) patients. Anticoagulant treatment was withdrawn in 5 (6.3%) patients at discharge. Eleven (13.7%) patients revisited the ED 30 days after hospital discharge for bleeding episodes. No differences in the frequency of revisit to the ED were observed in the patients who changed their anticoagulant treatment at discharge. In the multivariate analysis, chronic kidney disease was the only factor significantly associated with revisits at 30 days. Conclusions Elderly patients who experience a first episode of gastrointestinal bleeding have a high risk of revisiting the ED for a bleeding episode, with no particular differences between the types of anticoagulant prescribed at discharge. |
| Databáze: | OpenAIRE |
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