The association between antithrombotics (ATs) and the risk of gastrointestinal bleeding is well known; however, data regarding the influence of ATs on outcomes are scarce. The goals of this study are: (i) to assess the impact of prior AT therapy on in-hospital and 6-month outcomes and (ii) to determine the re-initiation rate of the ATs after a bleeding event. All patients with upper gastrointestinal bleeding (UGB) who underwent urgent gastroscopy in three centres from 1 January 2019 to 31 December 2019 were retrospectively analysed. Propensity score matching (PSM) was used. Among 333 patients [60% males, mean age 69.2 (±17.3) years], 44% were receiving ATs. In multivariate logistic regression, no association between AT treatment and worse in-hospital outcomes was observed. Development of haemorrhagic shock led to worse survival [odds ratio (OR) 4.4, 95% confidence interval (CI) 1.9-10.2, P < 0.001; after PSM: OR 5.3, 95% CI 1.8-15.7, P = 0.003]. During 6-months follow-up, higher age (OR 1.0, 95% CI 1.0-1.1, P = 0.002), higher comorbidity (OR 1.4, 95% CI 1.2-1.7, P < 0.001), a history of cancer (OR 3.6, 95% CI 1.6-8.1, P < 0.001) and a history of liver cirrhosis (OR 2.2, 95% CI 1.0-4.4, P = 0.029) were associated with higher mortality. After a bleeding episode, ATs were adequately re-initiated in 73.8%. Previous AT therapy does not worsen in-hospital outcomes in after UGB. Development of haemorrhagic shock predicted poor prognosis. Higher 6-month mortality was observed in older patients, patients with more comorbidities, with liver cirrhosis and cancer.

2nd Department of Internal Medicine 3rd Faculty of Medicine Charles University and University Hospital Kralovske Vinohrady 100 00 Prague Czech Republic

Cardiocenter 3rd Faculty of Medicine Charles University and University Hospital Kralovske Vinohrady Ruska 87 100 00 Prague Czech Republic

Cardiocenter Hospital Karlovy Vary 360 01 Karlovy Vary Czech Republic

Department of Anaesthesia and Intensive Care 3rd Faculty of Medicine Charles University and University Hospital Kralovske Vinohrady 100 00 Prague Czech Republic

Department of Gastroenterology Hospital Cheb 350 02 Cheb Czech Republic

Department of Gastroenterology Hospital Karlovy Vary 360 01 Karlovy Vary Czech Republic

Department of General Surgery 3rd Faculty of Medicine Charles University Faculty Hospital Kralovske Vinohrady 100 00 Prague Czech Republic

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