Multicenter Study of the Hemorrhage Risk after Endoscopic Mucosal Resection Associated with Direct Oral Anticoagulants
Backgrounds and Aims. Recently, direct oral anticoagulants (DOACs) have become widely used for preventing thromboembolism. However, postoperative hemorrhage (POH) is a major complication associated with endoscopic mucosal resection (EMR) for colorectal lesions. In this multicenter study, we analyzed...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2019/5743561 |
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| author | Ritsu Yasuda Naohisa Yoshida Takaaki Murakami Ryohei Hirose Ken Inoue Osamu Dohi Yuji Naito Yutaka Inada Takashi Okuda Daisuke Hasegawa Kotaro Okuda Kiyoshi Ogiso Yoshikazu Inagaki Koichi Soga Akira Tomie Yoshito Itoh |
| author_facet | Ritsu Yasuda Naohisa Yoshida Takaaki Murakami Ryohei Hirose Ken Inoue Osamu Dohi Yuji Naito Yutaka Inada Takashi Okuda Daisuke Hasegawa Kotaro Okuda Kiyoshi Ogiso Yoshikazu Inagaki Koichi Soga Akira Tomie Yoshito Itoh |
| author_sort | Ritsu Yasuda |
| collection | DOAJ |
| description | Backgrounds and Aims. Recently, direct oral anticoagulants (DOACs) have become widely used for preventing thromboembolism. However, postoperative hemorrhage (POH) is a major complication associated with endoscopic mucosal resection (EMR) for colorectal lesions. In this multicenter study, we analyzed the incidence of POH after EMR associated with DOACs and explored the associated risk factors. Materials and Methods. This study was a multicenter retrospective cohort study conducted at 8 Japanese institutions. A total of 2062 cases that underwent EMR for colorectal lesions at these 8 institutions from October 2016 to September 2017 were analyzed. The cases were divided into 4 groups: the DOAC group (63 cases), warfarin group (34 cases), antiplatelet group (185 cases), and no antithrombotics group (1780 cases). In all lesions of the DOAC and warfarin groups, endoscopic clipping was performed after EMR. The rate of POH in the DOAC group, patients’ clinical characteristics, the risk factors of POH, and the rate of thromboembolism due to stopping DOACs were compared with other groups. Results. The rates of POH were 7.9%∗ (5/63), 2.9% (1/34), 3.2% (6/185), and 0.6%∗∗ (11/1780) in the DOAC, warfarin, antiplatelet, and no antithrombotics groups, respectively (∗ vs. ∗∗, p<0.001). Regarding risk factors, the tumor size with POH (mm) was significantly bigger than that without POH (16.2±8.3 vs. 7.2±4.9, p<0.001). There were no significant differences in the rates of POH based on the type of DOAC. In addition, no thromboembolisms occurred due to stopping of DOAC treatment. Conclusions. Patients receiving DOACs had significantly higher rates of POH after EMR than those without antithrombotics. |
| format | Article |
| id | doaj-art-a8bd8257646c4cfbae207a67757108ff |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-a8bd8257646c4cfbae207a67757108ff2025-02-03T06:12:34ZengWileyGastroenterology Research and Practice1687-61211687-630X2019-01-01201910.1155/2019/57435615743561Multicenter Study of the Hemorrhage Risk after Endoscopic Mucosal Resection Associated with Direct Oral AnticoagulantsRitsu Yasuda0Naohisa Yoshida1Takaaki Murakami2Ryohei Hirose3Ken Inoue4Osamu Dohi5Yuji Naito6Yutaka Inada7Takashi Okuda8Daisuke Hasegawa9Kotaro Okuda10Kiyoshi Ogiso11Yoshikazu Inagaki12Koichi Soga13Akira Tomie14Yoshito Itoh15Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, JapanDepartment of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, JapanDepartment of Gastroenterology, JCHO Kyoto Kuramaguchi Medical Center, Kyoto, JapanDepartment of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, JapanDepartment of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, JapanDepartment of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, JapanDepartment of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, JapanDepartment of Gastroenterology, North Medical Center Kyoto Prefectural University of Medicine, Kyoto, JapanDepartment of Gastroenterology, Fukuchiyama City Hospital, Kyoto, JapanDepartment of Gastroenterology, Ayabe City Hospital, Kyoto, JapanDepartment of Gastroenterology, Kyoto Kujo Hospital, Kyoto, JapanDepartment of Gastroenterology, Osaka General Hospital of West Japan Railway Company, Osaka, JapanDepartment of Gastroenterology, Nishijin Hospital, Kyoto, JapanDepartment of Gastroenterology, Nishijin Hospital, Kyoto, JapanDepartment of Gastroenterology, Kyoto Yamashiro General Medical Center, Kyoto, JapanDepartment of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, JapanBackgrounds and Aims. Recently, direct oral anticoagulants (DOACs) have become widely used for preventing thromboembolism. However, postoperative hemorrhage (POH) is a major complication associated with endoscopic mucosal resection (EMR) for colorectal lesions. In this multicenter study, we analyzed the incidence of POH after EMR associated with DOACs and explored the associated risk factors. Materials and Methods. This study was a multicenter retrospective cohort study conducted at 8 Japanese institutions. A total of 2062 cases that underwent EMR for colorectal lesions at these 8 institutions from October 2016 to September 2017 were analyzed. The cases were divided into 4 groups: the DOAC group (63 cases), warfarin group (34 cases), antiplatelet group (185 cases), and no antithrombotics group (1780 cases). In all lesions of the DOAC and warfarin groups, endoscopic clipping was performed after EMR. The rate of POH in the DOAC group, patients’ clinical characteristics, the risk factors of POH, and the rate of thromboembolism due to stopping DOACs were compared with other groups. Results. The rates of POH were 7.9%∗ (5/63), 2.9% (1/34), 3.2% (6/185), and 0.6%∗∗ (11/1780) in the DOAC, warfarin, antiplatelet, and no antithrombotics groups, respectively (∗ vs. ∗∗, p<0.001). Regarding risk factors, the tumor size with POH (mm) was significantly bigger than that without POH (16.2±8.3 vs. 7.2±4.9, p<0.001). There were no significant differences in the rates of POH based on the type of DOAC. In addition, no thromboembolisms occurred due to stopping of DOAC treatment. Conclusions. Patients receiving DOACs had significantly higher rates of POH after EMR than those without antithrombotics.http://dx.doi.org/10.1155/2019/5743561 |
| spellingShingle | Ritsu Yasuda Naohisa Yoshida Takaaki Murakami Ryohei Hirose Ken Inoue Osamu Dohi Yuji Naito Yutaka Inada Takashi Okuda Daisuke Hasegawa Kotaro Okuda Kiyoshi Ogiso Yoshikazu Inagaki Koichi Soga Akira Tomie Yoshito Itoh Multicenter Study of the Hemorrhage Risk after Endoscopic Mucosal Resection Associated with Direct Oral Anticoagulants Gastroenterology Research and Practice |
| title | Multicenter Study of the Hemorrhage Risk after Endoscopic Mucosal Resection Associated with Direct Oral Anticoagulants |
| title_full | Multicenter Study of the Hemorrhage Risk after Endoscopic Mucosal Resection Associated with Direct Oral Anticoagulants |
| title_fullStr | Multicenter Study of the Hemorrhage Risk after Endoscopic Mucosal Resection Associated with Direct Oral Anticoagulants |
| title_full_unstemmed | Multicenter Study of the Hemorrhage Risk after Endoscopic Mucosal Resection Associated with Direct Oral Anticoagulants |
| title_short | Multicenter Study of the Hemorrhage Risk after Endoscopic Mucosal Resection Associated with Direct Oral Anticoagulants |
| title_sort | multicenter study of the hemorrhage risk after endoscopic mucosal resection associated with direct oral anticoagulants |
| url | http://dx.doi.org/10.1155/2019/5743561 |
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