Gastrointestinal bleeding
Conditions
Interventions
Queue 1: Patients with peptic ulcer bleeding associated with aspirin/P2Y12 inhibitors alone:N/A
Cohort 2: Patients with peptic ulcer bleeding associated with dual antiplatelet therapy (aspirin+P2Y12 inhibitor: Clopidogrel/Ticagrelor, etc.):N/A
Queue 3: Patients with lower gastrointestinal bleeding associated with aspirin/P2Y12 inhibitors alone in the queue:N/A
Queue 4: Patients with lower gastrointestinal bleeding associated with dual antiplatelet therapy:N/A
Sponsors
Beijing Friendship Hospital, Capital Medical University
Eligibility
Sex/Gender
All
Age
18 Years to 100 Years
Inclusion criteria
Inclusion criteria: 1) Hospitalization or emergency admission due to gastrointestinal bleeding; 2) Age = 18 years old; 3) Patients who are taking aspirin/P2Y12 inhibitors alone for secondary prevention or taking dual antiplatelet therapy, and have taken aspirin and/or P2Y12 inhibitors for = 1 week cumulatively within one month before bleeding; 4) Peptic ulcer (gastric, duodenal ulcer) bleeding confirmed by gastroscopy, or colorectal bleeding confirmed by colonoscopy, or small intestinal bleeding confirmed by enteroscopy/capsule, or suspected small bowel bleeding with negative gastroscopy and colonoscopy.
Exclusion criteria
Exclusion criteria: 1) Gastroscopy and colonoscopy have not been performed (if the etiology has been identified by gastroscopy or colonoscopy alone, it is not required to do all of them). 2) Does not meet the indications for secondary preventive medication; 3) No GIB related symptoms like hematemesis, melena, blood in stool or circulatory failure et al within 1 week before admission; 4) Gastrointestinal bleeding caused by other reasons such as rupture of esophageal and gastric varices, cardiac tear, acute hemorrhagic gastritis, biliary tract bleeding, benign and malignant tumors, hemorrhoids, anal fissure, trauma, foreign body or other physical and chemical factors; 5) Accumulative use of the following drugs for more than 1 week within 1 month before bleeding: heparin, low molecular weight heparin, warfarin, rivaroxaban, apixaban, edoxaban, dabigatran, bivalirudin , Argatroban and other anticoagulants; 6) History of cerebral hemorrhage within 3 months before admission, or history of hospital visits or blood transfusion for bleeding from other parts out of digestive tract caused by non-trauma; 7) Hospitalization, endoscopic treatment, and blood transfusion due to gastrointestinal bleeding within 3 months before admission; 8) Gastrointestinal endoscopic surgery (ESD, EMR, papillatomy, stent, etc.) within 3 months after gastrointestinal surgery (such as partial resection, diversion, fistula, etc., excluding appendectomy), endoscopic biopsy, puncture, small polypectomy within one month; 9) Inflammatory bowel disease, ischemic bowel disease, intestinal obstruction, gastrointestinal infectious disease, systemic disease gastrointestinal involvement; 10) Surgery, major trauma (traumatic brain injury, multiple fractures, rupture of internal organs, etc.), severe infection (sepsis, septic shock, multiple organ dysfunction syndrome, etc.) within 3 months; 11) Blood system diseases such as leukemia, lymphoma, aplastic anemia, myelodysplastic syndrome, autoimmune hemolysis, coagulation dysfunction (such as platelets 1.5), etc.; 12) Malignant tumor or history of malignant tumor; 13) Decompensated liver cirrhosis (ascites, variceal bleeding, hepatic encephalopathy, etc.), renal failure requiring dialysis or glomerular filtration rate (eGFR) <15ml/min/1.73m2 (CKD EPI formula), acute exacerbation of cardiopulmonary disease, etc.; 14) Combined with mental illness, senile dementia, or other mental abnormalities, unable to express subjective wishes; 15) Pregnant or lactating women; 16) Unable to sign the informed consent form, do not agree to follow-up follow-up, or fail to complete baseline data collection.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| All-cause case fatality rate;Incidence of gastrointestinal rebleeding;Incidence of ischemic cardiovascular and cerebrovascular events; | — |
Secondary
| Measure | Time frame |
|---|---|
| Death related to gastrointestinal rebleeding;Death related to ischemic cardiovascular or cerebrovascular events death;Death related to other causes of hemorrhage/embolic events; | — |
Countries
China
Contacts
Public ContactChuan-Guo Guo
Beijing Friendship Hospital, Capital Medical University
Outcome results
None listed