The Role and Importance of Antiagregan, Anticoagulant Drugs in the Etiology of Upper Gastrointestinal System Bleeding in Elderly

INTRODUCTION: In this study, we aimed to determine the role of anticoagulants and antiagregan medications in the etiology and prognosis of the upper gastrointestinal system (GIS) bleeding in elderly patients.
METHODS: One hundred and eighty-four patients who were admitted to the emergency department with the complaints of upper GIS bleeding between January and December 2016 were evaluated retrospectively regarding the age, gender, complaints, drugs, endoscopy findings, intensive care requirement and mortality.
RESULTS: The mean age of 184 patients was 78.3±7.9 years. 112 (60.9%) of them were male and 72 (39.1%) of them were female. 128 (69.6%) of the patients applied with only melena, 32(17.4%) with only hematemesis and 24 (13%) were admitted with both hematemesis and melena. Of the patients, 139 (75.9%) were treated in the internal medicine clinic and 31 (16.8%) were treated in the intensive care unit and 12 (6.5%) were expired. The most commonly used drug was acetylsalicylic acid (ASA) (31.5%) and the most common endoscopic finding was peptic ulcer (55.4%). The mean age of the patients treated in the intensive care unit was 81±7.2years, and 18 (58.1%) of those patients were male. The most common endoscopic finding was peptic ulcer- Forrest 2A (16.2%) and ASA (35.5%) was also the most common drug in that group. The mean age of the 12 patients who were expired was 75.3±7.2 years and 8 (66.7%) of them were male. In 12 patients, the most common endoscopic finding was the peptic ulcer and the most frequent drug was warfarin (33%).
DISCUSSION AND CONCLUSION: Antiagregan, anticoagulant, NSAI drugs have significant effects on etiology and prognosis of the upper GIS bleeding in the elderly. Gastroprotective drugs should be added to the treatment of patients using these drugs.

Yaşlılardaki üst gastrointestinal sistem kanamalarında antiagregan, antikoagülan ilaçların etiyolojideki yeri ve önemi

GİRİŞ ve AMAÇ: Yaşlı hastalardaki üst gastrointestinal sistem kanamalarında, antikoagülan ve antiangregan ilaçların etiyolojideki yeri ve prognoza etkisini belirlemeyi amaçladık.
YÖNTEM ve GEREÇLER: Ocak – Aralık 2016 tarihlerinde acil dahiliyeye üst GİS kanama şikayeti ile gelen 184 hasta retrospektif olarak yaş, cinsiyet, başvuru şikayeti, kullandıkları ilaçlar,endoskopi bulguları, yoğun bakım ihtiyacı ve mortalite açısından değerlendirildi.
BULGULAR: 184 hastanın yaş ortalaması 78,3 +7,9 idi. 112’si(%60.9) erkek, 72’si(%39.1) kadın idi. Hastaların 128(%69.6)’i melena, 32(%17.4) ’si hematemez, 24(%13)‘ü ise hematemez ve melena şikayeti ile başvurdu. Hastaların 139’u (%75.9) dahiliye kliniğinde, 31’i(16.8) yoğun bakımda tedavi oldu, 12si (%6.5) vefat etti.. En fazla kullanılan ilaç asetilsalisik asit(ASA) (%31.5) en sık endoskopik bulgu peptik ülser ( %55.4) idi.Yoğun bakımda tedavi olanların yaş ortalaması 81+7.2, 18’i(%58.1) erkek idi. Endoskopik bulguları ise en sık peptik ülser Forrest 2A(%16.2) ve en sık ASA(%35.5) kullanıyorlardı.
Ex olan 12 hastanın yaş ortalaması 75,3+7.2, 8’i (% 66,7)erkek, idi. Endoskopik bulguları ise en sık peptik ülser Forrest 3 (%50) ve en sık varfarin(%33) kullanıyorlardı

TARTIŞMA ve SONUÇ: Yaşlılardaki üst GİS kanamalarında antiagregan, antikoagülan, NSIA ilaçların etiyolojide ve prognoz üzerinde önemli etkileri vardır. Bu ilaçları kullanan hastaların tedavisine protectiv ilaçlar eklenmelidir.