Gastroduodenoscopy for screening patients scheduled for oral anticoagulant therapy: Incidence and age-dependence of potentially bleeding pathologies

This retrospective study was designed to shed light on the incidence and age-dependence of potentially bleeding pathologies in the upper gastrointestinal tract of asymptomatic patients scheduled for oral anticoagulant therapy. Gastroduodenoscopy was routinely performed during screening studies. The incidence of abnormalities was compared with gastroscopy findings of patients with epigastric symptoms. Only pathologies likely to bleed were considered. These included gastric ulcers, duodenal ulcers, esophageal varices, esophagitis, erosions, malformations and hemorrhages. Results: 18.23 % of the patients (n = 746) undergoing gastroscopy prior to scheduled oral anticoagulant therapy were found to present with abnormalities versus 18.44 % of those with epigastric symptoms (n = 1,627). In the group scheduled for oral anticoagulant therapy, the rate of pathologies did not significantly increase with increasing age. Conclusions: The unexpectedly high incidence of potentially bleeding pathologies in asymptomatic patients scheduled for anticoagulant therapy should prompt screening gastroduodenoscopies irrespective of the patients' age prior to instituting treatment.