Abstract
The clinical characteristics and outcomes of low-dose aspirin-induced bleeding gastroduodenal ulcers treated with endoscopic hemostasis were investigated retrospectively. All 231 cases examined had cerebrovascular and/or cardiovascular disease, and 91 (39.4%) of these patients developed bleeding gastroduodenal ulcers during hospitalization for comorbidities. Of the 231 cases, 23 (10.0%) died. In 7 of those 23 patients, endoscopic hemostasis failed. In the remaining 16 cases, endoscopic hemostasis was successful, but bleeding resulted in deterioration of the comorbidities and complications of infection and thromboembolism, ultimately causing death. Multivariate analysis revealed that high Charlson Comorbidity Index scores, calculated comorbidities and complications such as diabetes, renal failure, cerebrovascular and/or cardiovascular disease, renal failure with hemodialysis, presence of multiple bleeding lesions, and in-hospital development of bleeding gastroduodenal ulcers were significant factors related to these deaths during hospitalization. In such cases, appropriate preventive measures for gastroduodenal ulcer bleeding and management for comorbidities and complication after bleeding are required. In the 7 cases, the complication of thromboembolism appeared while antithrombotic drugs such as aspirin were discontinued due to bleeding. Therefore, early resumption of antithrombotic drugs after successful hemostasis, as well as rapid and reliable endoscopic hemostasis, is desirable to prevent thromboembolism.
