PPIs and Beyond : A Framework for Managing Anticoagulation-Related Gastrointestinal Bleeding in the Era of COVID-19
Coronavirus disease of 2019 (COVID-19) can be associated with high morbidity and mortality; patients with severe clinical manifestations may develop significant coagulopathy as well as unexpected thromboembolic complications. In response, centers are increasingly treating selected patients with intermediate-dose prophylactic or even therapeutic dose anticoagulation in order to prevent potentially catastrophic thrombotic complications. With this changing practice, the authors suspect that inpatient gastrointestinal consult teams across the country will be frequently managing COVID-19 patients with gastrointestinal bleeding (GIB). In order to reduce potentially avoidable hospital readmissions for GIB while improving patient outcomes, it is imperative to appropriately risk-stratify patients prior to initiation of anticoagulation. In this review, we discuss how to appropriately identify high-risk patients for GIB and how to mitigate GIB risk with proton-pump inhibitor co-therapy, medication reconciliation, and Helicobacter pylori testing and treating in this complex and morbid population.
| Media Type: |
Electronic Article |
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| Year of Publication: |
2020 |
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| Contained In: |
Digestive diseases and sciences - Vol. 65, No. 8 (2020), p. 2181-2186 |
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| Language: |
English |
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| Contributors: |
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| Links: |
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| Notes: |
Date Completed 31.07.2020 Date Revised 18.12.2020 published: Print Citation Status MEDLINE Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine |
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| Physical Description: |
Online-Ressource |
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| doi: |
10.1007/s10620-020-06408-x |
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| PMID: |
32537704 |
| PPN (Catalogue-ID): |
NLM312066597 |
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| 500 | |a Date Revised 18.12.2020 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 500 | |a Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine | ||
| 520 | |a Coronavirus disease of 2019 (COVID-19) can be associated with high morbidity and mortality; patients with severe clinical manifestations may develop significant coagulopathy as well as unexpected thromboembolic complications. In response, centers are increasingly treating selected patients with intermediate-dose prophylactic or even therapeutic dose anticoagulation in order to prevent potentially catastrophic thrombotic complications. With this changing practice, the authors suspect that inpatient gastrointestinal consult teams across the country will be frequently managing COVID-19 patients with gastrointestinal bleeding (GIB). In order to reduce potentially avoidable hospital readmissions for GIB while improving patient outcomes, it is imperative to appropriately risk-stratify patients prior to initiation of anticoagulation. In this review, we discuss how to appropriately identify high-risk patients for GIB and how to mitigate GIB risk with proton-pump inhibitor co-therapy, medication reconciliation, and Helicobacter pylori testing and treating in this complex and morbid population | ||
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