{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T05:10:08Z","timestamp":1788930608255,"version":"build-2803163510"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To evaluate clinical patterns and prognosis of gastrointestinal hemorrhage (GIH) in patients on antithrombotic therapy (AT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>This retrospective study included patients hospitalized with GIH between January 2010 and January 2020 at two tertiary care centers in Riyadh, Saudi Arabia. Demographics, clinical\/laboratory\/endoscopic findings, and outcomes were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The study included 759 GIH patients: 354 AT users and 405 non-users. AT users were older (69.2 \u00b1 13.9 vs 59.7 \u00b1 17.1 years;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.0001) with more cardiovascular comorbidities: hypertension (72.0% vs 38.5%), diabetes (63.3% vs 31.4%), ischemic heart disease (28.0% vs 4.7%), and stroke (15.0% vs 3.0%) (for all,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.0001). Endoscopy showed AT users had higher erosive gastritis (19.2% vs 10.4%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.001) and colonic ulcers (9.9% vs 5.7%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.029), while non-users had more esophageal varices (24.4% vs 12.4%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.0001) and hemorrhoids (25.9% vs 16.4%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.001). AT users required more transfusions (1.43 \u00b1 2.5 vs. 0.95 \u00b1 1.8 units;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.005), had lower hemoglobin (98.9 \u00b1 29.1 vs. 105.7 \u00b1 30.9 g\/L;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.002), higher creatinine (137.89 \u00b1 138.5 vs. 111.3 \u00b1 136.3 \u00b5mol\/L;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.011), more ICU admissions (28.5% vs. 19.0%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.002), and higher mortality (15.8% vs. 8.9%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.042). Independent predictors of mortality were AT (adjusted odds ratio [aOR]: 2.067, 95% CI: 1.102\u20133.879;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.024), alongside liver cirrhosis (aOR: 2.573, 95% CI: 1.26\u20135.252;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.009), malignancy (aOR: 2.836, 95% CI: 1.481\u20135.431;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.002), transfusions (aOR: 1.246, 95% CI: 1.141\u20131.361;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), and serum urea (aOR: 1.037; 95% CI: 1.017\u20131.057;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Patients on antithrombotic therapy with gastrointestinal hemorrhage present with distinct risk profiles, severe anemia\/renal impairment, higher resource utilization, and significantly increased mortality. These high-risk patients require careful management to improve their clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/sjmms.sjmms_713_24","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T17:03:52Z","timestamp":1760461432000},"page":"279-286","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Gastrointestinal Hemorrhage in Patients Receiving Antithrombotic Therapy: Clinical Patterns and Prognosis from Two Tertiary Care Hospitals"],"prefix":"10.4103","volume":"13","author":[{"given":"Hamdan S.","family":"AlGhamdi","sequence":"first","affiliation":[{"name":"King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"},{"name":"King Abdullah International Research Centre, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"},{"name":"Department of Hepatobiliary Sciences, and Organs Transplant Centre, Hepatology Section, King Abdulaziz Medical City of National Guard, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed A.","family":"Koshan","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasser F.","family":"AlOtaibi","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahad M.","family":"AlOtaibi","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faisal F.","family":"AlSubaie","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hussain A.","family":"Ekhuraidah","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rayan H.","family":"Al Zahrani","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abed A.","family":"AlLehibi","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia"},{"name":"Department of Gastroenterology and Hepatology, King Fahad Medical City, Ministry of Health, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Najd S.","family":"AlGazlan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulrahman A.","family":"Aljumah","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,10,14]]},"reference":[{"key":"R1-20251015","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1093\/eurheartj\/ehz425","article-title":"ESC Scientific Document Group. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes","volume":"41","author":"Knuuti","year":"2020","journal-title":"Eur Heart J"},{"key":"R2-20251015","doi-asserted-by":"crossref","first-page":"1406","DOI":"10.1056\/NEJM199211123272002","article-title":"Warfarin in the prevention of stroke associated with nonrheumatic atrial fibrillation. 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