Recent use of NSAID and NOAC medications are associated with a positive CT arteriogram. View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-04-04

AUTHORS

Muhammad A Shafqet, Alexander Tonthat, Paola Esparragoza, Butros Toro, Adam C Ehrlich, Frank K Friedenberg

ABSTRACT

BACKGROUND: Computed tomography angiography (CTA) is a diagnostic modality utilized in patients with suspected active lower gastrointestinal (GI) bleeding. CTA use in clinical practice is limited by the risk of contrast-induced nephropathy, and the loss of patients from direct physician observation while undergoing the test. Identifying clinical predictors of a positive result would be useful in guiding physician utilization of CTA studies. METHODS: We performed a single-center retrospective study to determine which clinical predictors are associated with a positive CTA. Binary logistical regression modeling was used to identify the independent predictors and the results were expressed as adjusted odds ratios with corresponding 95% CI . RESULTS: 262 patients met inclusion criteria and there were 61 (23.3%) positive CTA exams. In unadjusted analysis those who were CTA positive were more likely to require management in the intensive care unit (85.2% vs. 14.8%, p < 0.01) and being CTA positive was associated with a significantly increased in-hospital mortality (14.8% vs. 4.5%, p < 0.01). The use of a novel oral anticoagulant (NOAC) in the week prior to presentation was associated with a positive CTA after adjustment for confounders (adjusted odds ratio = 3.89; 95% CI 1.05-14.43). Similarly, the use of a non-steroidal anti-inflammatory drug (NSAID) was associated with a positive CTA (OR 2.36; 1.03-5.41). Only 8% of patients experienced contrast-induced nephropathy. CONCLUSION: Use of either NOACs or NSAIDs in the previous week is independently associated with a positive CTA in the setting of acute lower GI bleeding. CTA exams appear to confer a low risk of contrast-induced nephropathy. More... »

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http://scigraph.springernature.com/pub.10.1007/s00261-019-02005-3

DOI

http://dx.doi.org/10.1007/s00261-019-02005-3

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1113185198

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30949782


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