OBJECTIVES: Patients with non-valvular atrial fibrillation (NVAF), due to the considerable risk of stroke, are usually treated with anticoagulant drugs such as warfarin, and direct oral anticoagulants (DOACs). One related adverse event to the use of oral anticoagulants is gastrointestinal bleeding, which causes considerable morbidity, increase in costs, and mortality.The main objective is to determine the use of resources and costs in the management of gastrointestinal bleeding associated with DOACs or warfarin in patients with NVAF from a group of hospitals in Colombia.

METHODS: This is a descriptive, retrospective study. Patients with NVAF treated with apixaban, rivaroxaban, dabigatran, or warfarin, admitted to hospitals for gastrointestinal bleeding between 01 January 2018 to 31 October 2022 were included in this study. Clinical and demographic characteristics and use of resources and cost variables were evaluated. The costs during hospitalization were extracted using billing databases (medications, procedures, stay, and medical consultations as well as laboratory tests and images). The cost was calculated with a 5% annual value discount to 2022-year values.

RESULTS: A total of 59 patients with gastrointestinal bleeding were included, with mean age of 82.9 years and male predominance (36 patients i.e. 61%). DOACs were identified in 50 (84.7%) and warfarin in 9 patients (15.2%). A total of 78% of patients had bleeding in the upper digestive tract, with a mean hospital stay of 6.4 days. The mean cost of bleeding care by patient was USD 480, being mainly associated with medications (mean: USD 280), and consultation and hospital stay (mean: USD 231).

CONCLUSIONS: The main driver of the cost of gastrointestinal bleeding caused by oral anticoagulants was medications to manage the bleeding followed by hospital stay. However, given the size and selection of the sample, the results should be interpreted with caution.