title: Gastrointestinal bleeding associated with antithrombotic therapy in the elderly in Japan.
abstract: OBJECTIVE
  We summarize data of patients with gastrointestinal bleeding (GIB) and discuss the relationship between antithrombotic drug use and age in patients with GIB.
  
  
  METHODS
  One-hundred and twenty patients with GIB were divided into two groups according to age (=75 years old and <75 years old). The causes and clinical outcome of each group were compared.
  
  
  RESULTS
  Forty-two patients received antithrombotic therapy. The main antithrombotic drugs were low dose aspirin (38 patients), ticlopidine (5 patients) and warfarin (3 patients). Compared with younger GIB patients, elderly patients had more coexisting illness and antithrombotic drugs. In patients taking antithrombotic drugs, upper GIB is more frequent than those not taking antithrombotic drugs (p<0.05) and antithrombotic drugs were the risk for GIB from erosive lesions of the esophagus or stomach. In the lower gastrointestinal tract, there was no difference of incidence related to antithrombotic use. The initial endoscopic hemostasis was performed in 14 patients. Eight varices patients received endoscopic vanding and 6 of 43 gastroduodenal ulcer patients had mechanical clip hemostasis.
  
  
  CONCLUSIONS
  From our findings, antithrombotic drugs were considered to be a risk for GIB. It might be important to prevent or minimize GIB in elderly patients prescribed antithrombotic drugs.
authors.affiliation: Department of Surgery, Shin-Nakama Hospital, Nakama, Japan. taketoshisuehiro2004@yahoo.co.jp
authors.forename: Taketoshi
authors.initials: T
authors.lastname: Suehiro
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Yakeishi
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Sakai
authors.forename: Koichi
authors.initials: K
authors.lastname: Matsuzaki
authors.forename: Kensaku
authors.initials: K
authors.lastname: Sanefuji
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Toyokawa
authors.forename: Kei
authors.initials: K
authors.lastname: Shioshita
authors.forename: Yumi
authors.initials: Y
authors.lastname: Sugie
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Okudaira
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kano
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Mine
authors.forename: Keiko
authors.initials: K
authors.lastname: Suetsugu
authors.forename: Fuminaga
authors.initials: F
authors.lastname: Suetsugu
authors.forename: Naohisa
authors.initials: N
authors.lastname: Suehiro
authors.forename: Kikuo
authors.initials: K
authors.lastname: Suhiro
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D001241:Aspirin / Q000009:adverse effects; D016009:Chi-Square Distribution; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects*; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced* / Q000208:ethnology / Q000628:therapy; D016558:Hemostasis, Endoscopic; D006489:Hemostatic Techniques; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D013988:Ticlopidine / Q000009:adverse effects; D016896:Treatment Outcome; D014859:Warfarin / Q000009:adverse effects; D055815:Young Adult
chemical_list: D005343:Fibrinolytic Agents; D014859:Warfarin; D013988:Ticlopidine; D001241:Aspirin