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Gross haematuria in the era of anticoagulant therapy – implications on treatment and diagnostic approaches in a large emergency department patient population

  • Introduction Treatment with anticoagulants or antiplatelet drugs can provoke gross haematuria. In some cases, this may demask urologic malignancies. The goal of this study was to determine the influence of anticoagulants and antiplatelet drugs on the diagnosis and therapy of patients with gross haematuria who presented in the emergency department. Methods This retrospective study analysed patients presenting with gross haematuria between January 1st, 2021 and December 31st, 2021 in a single centre university hospital. Information on pre-existing conditions, anticoagulant and antiplatelet medication, and the further diagnostic and treatment course was gathered with a follow-up time until December 31st, 2022. Results Nearly half of the 541 patients (49.5%) presenting with gross haematuria were taking anticoagulant or antiplatelet medication. Patients receiving these medications were more likely to need bladder irrigation (p < 0.001). They were also more likely to be hospitalizedIntroduction Treatment with anticoagulants or antiplatelet drugs can provoke gross haematuria. In some cases, this may demask urologic malignancies. The goal of this study was to determine the influence of anticoagulants and antiplatelet drugs on the diagnosis and therapy of patients with gross haematuria who presented in the emergency department. Methods This retrospective study analysed patients presenting with gross haematuria between January 1st, 2021 and December 31st, 2021 in a single centre university hospital. Information on pre-existing conditions, anticoagulant and antiplatelet medication, and the further diagnostic and treatment course was gathered with a follow-up time until December 31st, 2022. Results Nearly half of the 541 patients (49.5%) presenting with gross haematuria were taking anticoagulant or antiplatelet medication. Patients receiving these medications were more likely to need bladder irrigation (p < 0.001). They were also more likely to be hospitalized (p < 0.001) and receive operative intervention (p = 0.011). The most common cause for haematuria was malignant tumours. A malignant urologic disease was diagnosed in 27% of the patients. Among those who were diagnosed with a malignant disease, the number of patients taking anticoagulant medication was higher (p = 0.005). In a follow-up of 3 months, no thromboembolic events were observed after stopping or pausing anticoagulation or antiplatelet treatment. Conclusion Clinically significant gross haematuria is often associated with the intake of anticoagulant or antiplatelet medication and can unmask underlying malignant diseases. The intake of anticoagulation or antiplatelet therapy should not be a reason to postpone diagnostic and therapeutic measures.show moreshow less

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Metadaten
Author:Yushan Yang, Johanna Seidl, Simon Udo Engelmann, Maximilian Haas, Roman MayrORCiDGND, Maximilian Burger, Johannes Breyer, Markus Resch
URN:urn:nbn:de:bvb:384-opus4-1258330
Frontdoor URLhttps://opus.bibliothek.uni-augsburg.de/opus4/125833
ISSN:2688-4526OPAC
Parent Title (English):BJUI Compass
Publisher:Wiley
Place of publication:Weinheim
Type:Article
Language:English
Year of first Publication:2025
Publishing Institution:Universität Augsburg
Release Date:2025/10/22
Volume:6
Issue:10
First Page:e70099
DOI:https://doi.org/10.1002/bco2.70099
Institutes:Medizinische Fakultät
Medizinische Fakultät / Universitätsklinikum
Medizinische Fakultät / Lehrstuhl für Urologie
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):CC-BY 4.0: Creative Commons: Namensnennung