Table 4

ORs for postendoscopy GI bleeding, thromboembolism and death in patients treated with warfarin alone, DOACs plus heparin bridging and warfarin plus heparin bridging with reference to patients treated with DOACs alone, adjusting for high-risk endoscopic procedures (n=10 092)

Postendoscopy GI bleedingPostendoscopy thromboembolismPostendoscopy death
OR (95% CI)p ValueOR (95% CI)p ValueOR (95% CI)p Value
Anticoagulants with and without heparin bridging
 DOACs aloneReferenceReferenceReference
 Warfarin alone1.14 (0.91 to 1.43)0.2501.27 (0.89 to 1.83)0.1921.08 (0.79 to 1.48)0.619
 DOACs plus heparin bridging1.52 (1.25 to 1.85)<0.0012.60 (1.95 to 3.47)<0.0011.37 (1.05 to 1.79)0.023
 Warfarin plus heparin bridging1.69 (1.41 to 2.02)<0.0012.46 (1.86 to 3.26)<0.0011.53 (1.18 to 1.97)0.001
Endoscopic procedures
 PEGReferenceReferenceReference
 Upper GI haemostasis14.9 (10.9 to 20.4)<0.0011.15 (0.89 to 1.49)0.2750.73 (0.58 to 0.91)0.005
 Lower GI EMR7.10 (5.09 to 9.92)<0.0010.56 (0.41 to 0.78)<0.0010.06 (0.03 to 0.11)<0.001
 EST3.47 (2.40 to 5.03)<0.0010.87 (0.65 to 1.16)0.3340.18 (0.12 to 0.27)<0.001
 Lower GI haemostasis12.4 (8.64 to 17.9)<0.0011.23 (0.85 to 1.78)0.2830.47 (0.32 to 0.71)<0.001
 Upper GI ESD45.3 (32.5 to 63.3)<0.0010.71 (0.46 to 1.10)0.1230.08 (0.03 to 0.20)<0.001
 Lower GI polypectomy7.64 (5.08 to 11.5)<0.0010.48 (0.28 to 0.84)0.0100.02 (0.003 to 0.144)<0.001
 Lower GI ESD9.78 (6.12 to 15.6)<0.0010.61 (0.31 to 1.22)0.161NA*NA*
 EUS-FNA2.26 (1.05 to 4.84)0.0371.05 (0.60 to 1.85)0.8660.78 (0.47 to 1.29)0.332
 Upper GI EMR/polypectomy15.2 (9.21 to 25.0)<0.0010.46 (0.17 to 1.27)0.1350.06 (0.001 to 0.46)0.006
 Endoscopic balloon dilatation0.42 (0.06 to 3.10)0.3980.72 (0.31 to 1.66)0.4450.62 (0.31 to 1.23)0.170
 EVL19.7 (11.4 to 33.8)<0.0010.18 (0.03 to 1.30)0.0891.06 (0.54 to 2.05)0.874
 EIS11.9 (5.31 to 26.8)<0.0011.58 (0.56 to 4.46)0.3900.19 (0.03 to 1.41)0.105
  • *NA: no deaths occurred in association with any procedure.

  • DOACs, direct oral anticoagulants; EIS, endoscopic injection sclerotherapy; EMR, endoscopic mucosal resection; ESD, endoscopic submucosal dissection; EST, endoscopic sphincterotomy; EUS-FNA, endoscopic ultrasound-guided fine needle aspiration; EVL, endoscopic variceal ligation; PEG, percutaneous endoscopic gastrostomy.