Peri-Procedural Healthcare Costs of Thromboembolic and Bleeding Events in Patients on Direct Oral Anticoagulants Undergoing High-Risk Endoscopy

The study examined healthcare costs associated with complications in patients on direct oral anticoagulants (DOAC) or warfarin who underwent high-risk endoscopy. The analysis included 2,486 patients (median age 65 years, 61.5% male, 81% with atrial fibrillation). Bleeding occurred in 18% of patients within 7 days and in 22.9% within 90 days. Stroke or transient ischemic attack occurred in 0.5% within 7 days and in 1.7% within 90 days. Thromboembolic events were approximately 2.5 times more expensive than bleeding events. Stroke increased costs by $8,874 unadjusted and $5,798 adjusted. Bleeding increased costs by $3,471 unadjusted and $3,157 adjusted. Patients experiencing both bleeding and subsequent stroke had the highest costs (mean $23,716).