Impact of antithrombotic therapy on management and prognosis of patients hospitalized for upper gastrointestinal bleeding: a multicenter retrospective cohort study
In brief
Anticoagulant users had 4.5% mortality after upper GI bleeding, versus 8.4%
In this retrospective study of 928 hospitalized patients, 30-day mortality was lower among those taking anticoagulants alone than among those taking no antithrombotic drugs; the adjusted analysis also found lower odds of death. Antithrombotic use was not linked to differences in endoscopy, bleeding control, transfusion, or intensive care, and the observational findings do not show that these drugs prevent death.
- Journal
- Internal and emergency medicine (Q1)
- Published
- 9 October 2026
- Study design
- Retrospective cohort
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Mathilde De Caluwe, Manon Fainelli, Agathe Beauvais, Sarah Harzo, Clément Prebin, Florent Noel, et al.
- PMID
- 42850445
- DOI
- 10.1007/s11739-026-04555-z
Why clinicians should know about it
- Picked for Internal Medicine (paper of the day, 13 October 2026): Antithrombotic therapy impact on UGIB management and mortality
Abstract
BACKGROUND: Antithrombotic agents are frequently implicated in upper gastrointestinal bleeding (UGIB), yet their impact on prognosis and management remains unclear. The aim of this study was to assess the impact of pre-existing antithrombotic therapy on the management and prognosis of patients hospitalized for UGIB. METHODS: This study used data from a retrospective, multicenter cohort of adult patients hospitalized for UGIB between January 2019 and December 2020 in Greater Paris University Hospitals. Patients were categorized into four groups according to their pre-existing antithrombotic treatment: antiplatelet therapy, anticoagulant therapy, both, or none. The primary outcome was thirty-day mortality. Secondary outcomes included endoscopy, endoscopic hemostasis, and blood transfusion within 7 days, and intensive care unit admission. Associations were assessed using multivariable logistic regression and reported as adjusted odds ratios (aORs) with 95% confidence intervals (95%CIs). RESULTS: Among 928 patients, 226 (24%) were on antiplatelet therapy alone, 154 (17%) on anticoagulant therapy alone, 61 (7%) on combined therapy, and 487 (52%) received no antithrombotic treatment. Thirty-day mortality was 6.9%: 8.4% in the no-antithrombotic group, 6.2% in the antiplatelet group, 4.5% in the anticoagulant group, and 3.3% in the combined therapy group. Compared with the no-antithrombotic group, anticoagulant therapy alone was associated with lower mortality (aOR=0.28, 95% CI 0.10-0.83), while antiplatelet therapy alone or combined therapy were not significantly associated (aOR=0.47, 95% CI 0.19-1.14 and aOR=0.12, 95% CI 0.01-1.11, respectively). Neither anticoagulant nor antiplatelet therapy was associated with secondary outcomes. CONCLUSIONS: Antithrombotic therapy had no negative impact on the management or prognosis of patients hospitalized for UGIB.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.