Original articleClinical endoscopyBleeding after percutaneous endoscopic gastrostomy is linked to serotonin reuptake inhibitors, not aspirin or clopidogrel
Section snippets
Methods
We conducted a retrospective, single-center cohort study that included inpatients at the University of Virginia Hospital, which is a large quaternary-care center. Patients on the neurology and cardiothoracic services who underwent PEG from January 1999 to April 2009 were included. Patients were limited to the neurology and cardiothoracic services because they were more likely to require and be exposed to aspirin and/or clopidogrel before and after PEG. This study was approved by our
Patient characteristics
A total of 1091 patients were reviewed, and 101 patients were excluded. A total of 990 patients (525 men) with a median age of 69.8 years (range 18-95 years) underwent PEG during the 10-year study period and were included in the study (Table 1). PEGs ranged in size and included 24F (91.5%), 20F (8.4%), and 18F (0.1%) tubes. Primary diagnoses associated with these patients who required PEG included cerebrovascular accident (n = 377), intracranial hemorrhage (n = 259), other neurological
Discussion
GI bleeding is a clinically important adverse event after PEG placement. PEG is considered a higher risk procedure that has a reported bleeding rate of 2.5%.2, 3 Because of the effectiveness of aspirin and clopidogrel in the prevention of thrombotic vascular events in cardiovascular and cerebrovascular diseases4, 5, 6, 7, 8 and their critical role after coronary artery stent placement,9 endoscopists are increasingly asked to perform procedures in individuals who are on antiplatelet therapies.
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DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
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