RT Journal Article
T1 Consensus document of the Spanish Society of Digestives Diseases and the Spanish Society of Thrombosis and Haemostasis on massive nonvariceal gastrointestinal bleeding and direct-acting oral anticoagulants.
A1 Carballo, Fernando
A1 Albillos, Agusin
A1 Llamas, Pilar
A1 Orive, Aitor
A1 Redondo-Cerezo, Eduardo
A1 Rodriguez de Santiago, Enrique
A1 Crespo, Javier
AB there is limited experience and understanding of massive nonvariceal gastrointestinal bleeding during therapy with direct-acting oral anticoagulants. to provide evidenced-based definitions and recommendations. a consensus document developed by the Spanish Society of Digestives Diseases and the Spanish Society of Thrombosis and Haemostasis using modified Delphi methodology. A panel was set up of 24 gastroenterologists with experience in gastrointestinal bleeding, and consensus building was assessed over three rounds. Final recommendations are based on a systematic review of the literature using the GRADE system. panelist agreement was 91.53 % for all 30 items as a group, a percentage that was improved during rounds 2 and 3 for items where clinical experience is lower. Explicit disagreement was only 1.25 %. A definition of massive nonvariceal gastrointestinal bleeding in patients on direct-acting oral anticoagulants was established, and recommendations to optimize this condition's management were developed. the approach to these critically ill patients must be multidisciplinary and protocolized, optimizing decisions for an early identification of the condition and patient stabilization according to the tenets of damage control resuscitation. Thus, consideration must be given to immediate anticoagulation reversal, preferentially with specific antidotes (idarucizumab for dabigatran and andexanet alfa for direct factor Xa inhibitors); hemostatic resuscitation, and bleeding point identification and management.
PB Sociedad Espanola de Patologia Digestiva
SN 1130-0108
YR 2022
FD 2022/05/13
LK http://hdl.handle.net/10668/21736
UL http://hdl.handle.net/10668/21736
LA en
NO Carballo F, Albillos A, Llamas P, Orive A, Redondo-Cerezo E, Rodríguez de Santiago E, et al. Consensus document of the Spanish Society of Digestives Diseases and the Spanish Society of Thrombosis and Haemostasis on massive nonvariceal gastrointestinal bleeding and direct-acting oral anticoagulants. Rev Esp Enferm Dig. 2022 Jul;114(7):375-389.
DS RISalud
RD Apr 6, 2025