Antithrombotic Medication Use and Bleeding Risk in Medically Ill Patients After Hospitalization

Clinical and Applied Thrombosis/Hemostasis - Tập 19 Số 5 - Trang 504-512 - 2013
Charles E. Mahan1, Alex C. Spyropoulos2, Maxine D. Fisher3, Larry E. Fields4, Roger M. Mills5, Judith J. Stephenson3, An-Chen Fu3, Winslow Klaskala5,6
1Department of Outcomes Research, New Mexico Heart Institute, Albuquerque, NM, USA
2Department of Medicine, Division of Hematology/Oncology, Lenox Hill Hospital of the North Shore/Long Island Jewish Health System, New York, NY, USA
3HealthCore, Inc., Wilmington, DE, USA
4Janssen Scientific Affairs, LLC, Raritan, NJ, USA
5Janssen Research and Development, LLC, Raritan, NJ, USA
6This is a posthumous article for Winslow Klaskala.

Tóm tắt

Background: Hospitalized medically ill patients receiving antithrombotic medications experience increased risk of bleeding. We examined antithrombotic use, bleeding rates, and associated risk factors at 30 days post discharge. Methods: This retrospective database analysis included nonsurgical patients aged ≥40 years hospitalized for ≥2 days during 2005 to 2009. Previously cited, validated International Classification of Diseases, Ninth Revision, Clinical Modification codes for major bleeding were used to define clinically relevant bleeding. Results: Of the 327,578 patients, 9.1% received antithrombotic medications, of which 3.7% were anticoagulants. Rates of major and minor bleeding were 1.8% and 7.1%, respectively. Preindex gastroduodenal ulcer, thromboembolic stroke, blood dyscrasias, liver disease, and rehospitalization were the strongest predictors of major bleeding. Other risk factors included increasing age, male gender, and hospital stay of ≥3 days. Conclusions: Careful consideration of these demonstrated bleed-associated comorbidities before initiating anticoagulation or combining antithrombotic medications in medically ill patients may improve strategies for prevention of postdischarge thromboembolism.

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Thông tin
Thông tin xuất bản

Clinical and Applied Thrombosis/Hemostasis

Tập 19 Số 5

504-512

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