PWE-040 Antithrombotic medications in upper gi bleeding: frequency of use, timing of re-prescription & outcomes

Introduction Upper gastrointestinal bleeding (UGIB) is a common medical emergency 1 . The use of antithrombotic (AT) medications (antiplatelets or anticoagulants/DOACs) is increasing. These drugs significantly increase the risk of UGIB 2 . Our aim was to assess the use of AT medications and NSAIDs on outcome after UGIB and the timing of re-prescription of these drugs. Method A six month audit (01.04.16–30.09.16) of patients undergoing endoscopy for UGIB was conducted. Demographics, drug use and Full Rockall risk score (FRS) were calculated. Outcomes included transfusion, endoscopic therapy, re-bleeding Results 206 patients were identified. 48% were taking AT drugs or NSAIDs. Patients taking ATs were older (69 vs 53 years; p %; p=0.02) and varices less common (4% vs 15%; p vs those not. Need for transfusion (29% vs 27%) and need for endoscopic therapy (45% vs 55%) were similar in both groups. Aspirin and ADP-inhibitors were restarted vs those not on ATs there was no difference in rebleeding (4.11% vs 6.67%; p=0.501) or mortality (10.9% vs 7.07%; p=0.447). Conclusion Use of AT drugs is common in patients presenting with UGIB. Most patients are restarted on these medications References . Scottish Intercollegiate Guidelines Network [SIGN]. SIGN 105: Management of acute upper and lower gastrointestinal bleeding. SIGN; 2008. . Lanas, A, et al. Low Doses of Acetylsalicylic Acid Increase Risk of GI bleeding in a Meta-Analysis. Clin Gastro Hepatol 2011;9:762–768 . Gralnek I, et al. Diagnosis and management of nonvariceal upper gastrointestinal haemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) Guideline.”Endoscopy2015;47.10:a1-a46. Disclosure of Interest None Declared