Timing of rivaroxaban re-administration after upper gastrointestinal bleeding in patients with lower extremity deep venous thrombosis
10.3760/cma.j.cn341190-20220623-00519
- VernacularTitle:下肢深静脉血栓患者上消化道出血后利伐沙班恢复时机研究
- Author:
Huan MA
1
;
Junmin WANG
;
Li JIAO
;
Xiao FAN
;
Xia MENG
;
Liwei ZHAO
Author Information
1. 河北医科大学第三医院消化内科，石家庄 050000
- Keywords:
Venous thrombosis;
Lower extremity;
Gastrointestinal hemorrhage;
Rivaroxaban;
Proton pump inhibitors;
Blood platelets;
Hemoglobinometry;
Fibrin fibrinogen de
- From:
Chinese Journal of Primary Medicine and Pharmacy
2023;30(9):1314-1318
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the timing of rivaroxaban re-administration after upper gastrointestinal bleeding in patients with lower extremity deep venous thrombosis.Methods:The clinical data of 176 patients who suffered from lower limb deep vein thrombosis due to trauma or surgery and upper gastrointestinal bleeding due to oral rivaroxaban and received treatment in the Third Hospital of Hebei Medical University from May 2018 to October 2021 were retrospectively analyzed. These patients were divided into an early group (≤ 7 days) ( n = 84 cases) and a late group (> 7 days) ( n = 92 cases) according to the timing of rivaroxaban re-administration. All patients were followed up for 2 months to record hemoglobin, D-dimer, and platelet values. The progression of deep venous thrombosis of the lower extremities was observed. The rebleeding rate, progression of lower extremity deep venous thrombosis, and mortality were analyzed. Results:There were no significant differences in hemoglobin and D-dimer levels between the two groups on admission (both P > 0.05). After admission, the D-dimer level in the late group was (4.1 ± 2.3) mg/L, which was significantly higher than (3.1 ± 1.9) mg/L in the early group ( t = 3.17, P < 0.05). After admission, hemoglobin level in each group was significantly decreased compared with that on admission (both P < 0.05). The lowest hemoglobin level in the late group was (78.7 ± 8.3) g/L, which was significantly higher than (75.6 ± 8.2) g/L in the early group ( t = 2.32, P < 0.05). There was no significant difference in rebleeding rate between early and late groups [5.95% (5/84) vs. 1.08% (1/92)] (log-rank 3.07, P > 0.05). Lower extremity deep venous thrombosis progressed more slowly in the early group compared with the late group [2.38% (2/84) vs. 10.86% (10/92)] (log-rank = 4.61, P < 0.05). Conclusion:Rivaroxaban should be re-administered as soon as possible after upper gastrointestinal bleeding in patients with lower extremity deep venous thrombosis.
