Objective: This prospective observational study evaluated the clinical profile of adults presenting to the emergency department (ED) with non-traumatic bleeding and examined whether bleeding severity, antithrombotic use, and physiological/laboratory parameters were associated with in-hospital and 30-day mortality.
Material and Methods: Demographic data, comorbidities, medication exposure, bleeding site, vital signs, laboratory variables, and clinical outcomes were recorded using a standardized data collection form. Major bleeding was defined according to the International Society on Thrombosis and Haemostasis (ISTH) criteria. Group comparisons were performed using appropriate parametric or non-parametric tests, and variables associated with mortality were evaluated using multivariable logistic regression.
Results: Among 310 patients screened, 297 adults were included after exclusion of 13 patients with cirrhosis-related complications. Gastrointestinal bleeding was the most common presentation (48.1%), and 55.9% of patients were using at least one antithrombotic agent. Major bleeding was more frequent in older patients, males, patients with comorbidities, and those with central nervous system (CNS) or gastrointestinal bleeding. In-hospital mortality was 8.1%, and 30-day mortality was 12.1%. In the final multivariable model, major bleeding (OR=7.223, 95% CI: 2.268–23.005, p=0.001) and lower oxygen saturation (OR=0.757, 95% CI: 0.665–0.860, p<0.001) were independently associated with in-hospital mortality. CNS bleeding, hypertension, higher blood urea nitrogen, higher pulse rate, and lower oxygen saturation were independently associated with 30-day mortality.
Conclusion: In adults presenting to the ED with non-traumatic bleeding, mortality appeared to cluster around bleeding severity and markers of physiological compromise rather than antithrombotic exposure alone. Early risk stratification using bleeding site, ISTH major bleeding criteria, oxygen saturation, pulse rate, and renal function markers may help identify patients requiring closer monitoring and more aggressive management.
Keywords: Antithrombotic agents, emergency department, major bleeding, mortality, non-traumatic bleeding, risk stratification
, Ömer Yasir Boz2 
