Given the increasing number of patients on Anti-platelet/Anti-coagulation therapy we aimed to evaluate outcome (mortality, morbidity & length of stay) in cohort with gastrointestinal bleeding requiring ICU admission.
We reviewed 48 patients admitted with the diagnoses of GIB, to the medical ICU. All patients had a primary diagnosis of GIB. The charts were reviewed for demographics (age, sex, PMH), initial platelet count, INR, use of Anti-platelet therapy (Aspirin or Plavix) and/or use of Anti-coagulation therapy (Coumadin), prior to hospitalization. Patients were divided into 3 groups based on platelet/AC therapy; Group 1 consisted of 26 patients on no anti-platelet/AC, group 2 had 15 patients on anti-platelet therapy, and group 3 consisted of 7 patients on AC +/− anti-platelet therapy. Mortality, overall hospital LOS, transfusion requirements, need for intubation and vasopressers were evaluated.
Patients were analyzed in 3 groups (see table 2). Compared to group 1, patients in the AC group (group 3) had increased need for PRBC (6.6 units/pt vs. 3.6 units/pt), FFP (6.3 units/pt vs. 1.2 units/pt), and LOS (10 days vs. 6.2 days). Patients in the anti-platelet group (group 2) had similar outcomes to group 1, with LOS (5.1 days vs. 6.3 days), PRBC requirement of 2.4units/pt vs. 3.6 units/pt. Between the 3 groups, there were no significant differences in mortality, respiratory failure and shock.
We found that patients admitted to the MICU with the diagnoses of GIB on Anti-coagulation therapy require higher number of PRBC and FFP compared to patients not on Coumadin. Prior administration of Anti-platelet therapy did not affect transfusion requirements and LOS.
ICU patients with GIB on Coumadin, but not Anti-platelet therapy, have higher transfusion requirement and higher LOS.
Amir Akhzari, No Financial Disclosure Information; No Product/Research Disclosure Information