Evidence map›Paper›PMID 39744289›Full record

ArticleCureus2024

Comparative Outcomes of Warfarin vs. Direct Oral Anticoagulants (DOACs) in Anticoagulant-Related Gastrointestinal Bleeding: A Single-Center Study.

Naqeeb Ullah, Wajeeha Arif, Mohammad B Khan, Heywad T Aioby, Iram Raza, Ambar Siddiq, Urooj Siddiq, Jamil Ahmad, Muhammad Hamza Ghufran, Ayiz Jan and 3 more

Abstract read
In one paragraph

Article in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Narrative Review of Management Strategies and Risk Mitigation for Gastrointestinal Bleeding in Atrial Fibrillation Patients Receiving Warfarin.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Naqeeb UllahInternal Medicine, Lady Reading Hospital, Peshawar, PAK.
Wajeeha ArifInternal Medicine, Khalifa Gul Nawaz Teaching Hospital, Bannu, PAK.
Mohammad B KhanClinical Sciences, Windsor University School of Medicine, Cayon, KNA.
Heywad T AiobyClinical Research, Windsor University School of Medicine, Cayon, KNA.
Iram RazaInternal Medicine, Pakistan Institute of Medical Sciences, Peshawar, PAK.
Ambar SiddiqInternal Medicine, Lady Reading Hospital, Peshawar, PAK.
Urooj SiddiqMedicine, Médecins du Monde-France, Pakistan Mission, Peshawar, PAK.
Jamil AhmadInternal Medicine, Lady Reading Hospital, Peshawar, PAK.
Muhammad Hamza GhufranMedicine, Lady Reading Hospital, Peshawar, PAK.
Ayiz JanMedicine, Saidu Medical College, Swat, PAK.
Sundas SafdarDiagnostic Radiology, Lady Reading Hospital, Peshawar, PAK.
Hanifullah HanfiMedicine, Mardan Medical Complex, Mardan, PAK.
Shahabuddin ZiaMedicine and Surgery, Khyber Medical University, Peshawar, PAK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe management of thromboembolic risk and the necessity for timely hemorrhage control make anticoagulant-related gastrointestinal (GI) bleeding clinically challenging.

objectiveThis study aimed to evaluate clinical outcomes (such as bleeding control and mortality) and the effectiveness of anticoagulation reversal techniques in patients with anticoagulant-related GI bleeding in emergency settings. METHODOLOGY: This prospective, observational study conducted at Lady Reading Hospital, Peshawar, from January to December 2023, included patients aged 18 or older with GI bleeding on warfarin or direct oral anticoagulants (DOACs). Key clinical data, including demographics and comorbidities, were collected. The study followed a multidisciplinary approach with emergency physicians, gastroenterologists, and surgeons. Pharmacologic management (Vitamin K for warfarin and idarucizumab for DOACs) was initiated based on clinical judgment, with endoscopic interventions performed within 24 hours if needed, and surgical intervention considered if other methods failed or complications arose. Outcomes such as bleeding control, transfusion needs, and mortality were tracked. Data were collected prospectively via case report forms, and patients were followed for up to six months post-discharge. Statistical analysis was performed using SPSS version 27 (IBM Corp., Armonk, NY), with descriptive statistics for all variables. Continuous variables were compared using independent t-tests, and categorical data were assessed using chi-square tests. Adjusted odds ratios were calculated for mortality and bleeding control outcomes, accounting for confounders.  Results: A total of 384 patients were included, with 180 (46.88%) on warfarin and 204 (53.12%) on DOACs. Bleeding control was significantly better in the DOAC group (170/204, 83.33% vs. 130/180, 72.22%,

conclusionsThe study demonstrates that DOACs offer better outcomes in bleeding control and mortality compared to warfarin in anticoagulant-related GI bleeding, emphasizing the importance of tailored treatment strategies. These findings highlight the potential benefits of DOACs in emergency settings, supporting the need for customized management plans to optimize patient outcomes.

Indexed as

anticoagulant therapyclinical outcomesemergency managementgastrointestinal bleedingmultidisciplinary care

Identifiers

PMID39744289
PMCPMC11688521

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.