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CC BY-NC-ND 4.0 · Endosc Int Open 2023; 11(01): E52-E59
DOI: 10.1055/a-1981-2946
Original article

Comparison of bleeding following gastrointestinal endoscopic biopsy in patients treated with and without direct oral anticoagulants

Takaaki Konishi
1   Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
2   Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
,
Sachiko Ono
3   Department of Eat-loss Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Akira Okada
4   Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Hiroki Matsui
2   Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
,
Masahiko Tanabe
1   Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Yasuyuki Seto
1   Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
5   Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Hideo Yasunaga
2   Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
› Author AffiliationsSupported by: Ministry of Health, Labour and Welfare (http://dx.doi.org/10.13039/501100003478) 21AA2007
Supported by: Ministry of Education, Culture, Sports, Science and Technology (http://dx.doi.org/10.13039/501100001700) 20H03907,21H03159
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Correction to:

Erratum: Comparison of bleeding following gastrointestinal endoscopic biopsy in patients treated with and without direct oral anticoagulantsEndosc Int Open 2023; 11(01): C2-C2
DOI: 10.1055/a-2031-2897

Abstract

Background and study aims Despite the widespread use of direct oral anticoagulants (DOACs), the association between DOAC use and complications (e. g., bleeding) following gastrointestinal endoscopic biopsy remains unclear. This study aimed to evaluate complications after biopsy in patients treated with DOACs in Japan, where biopsies would be generally performed without DOAC withdrawal based on guideline recommendations.

Patients and methods Using a Japanese nationwide database, we identified patients taking DOACs who underwent gastrointestinal endoscopic biopsy (n  = 2,769, DOAC group) and those not taking DOACs (n = 129,357, control group) from April 2015 to November 2020. We conducted 1:4 propensity score (PS) matching and overlap PS-weighting analyses with adjustment for background characteristics to compare occurrence of post-procedure hemorrhage and stroke within 1 week after biopsy, and thrombin use on the day of biopsy without a diagnosis of hemorrhage.

Results In total, 578 patients (0.44 %) developed post-procedure hemorrhage, and 13 patients (0.01 %) developed stroke. The DOAC group had more comorbidities than the control group. The PS matching analysis revealed no significant differences in post-procedure hemorrhage (odds ratio, 1.52 [95 % confidential interval, 0.96–2.41]) or stroke (1.00 [0.21–4.71]), whereas the DOAC group received thrombin more often than the control group (1.60 [1.30–1.95]). The results were equivalent in the overlap PS-weighting analysis.

Conclusions The PS analyses showed no significant differences in complications following gastrointestinal endoscopic biopsy between DOAC users and non-users. These results suggest the safety of endoscopic biopsy without DOAC withdrawal although the need for careful hemostasis remains.

Supplementary material



Publication History

Received: 29 April 2022

Accepted after revision: 15 November 2022

Accepted Manuscript online:
17 November 2022

Article published online:
13 January 2023

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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