Abstract Number: PB1118
Meeting: ISTH 2021 Congress
Background: Anticoagulant therapy (ACT) is widely used; however, there is little data on bleeding complications associated with ACT use in patients admitted to Internal Medicine wards – often elderly and/or with multiple comorbidities requiring a thorough assessment of its risk-benefit ratio.
Aims: To evaluate the prevalence of ACT use and related bleeding complications in patients admitted to Internal Medicine wards. To identify potential predictors of bleeding in ACT patients.
Methods: We conducted an observational, retrospective study using medical records of all consecutive patients discharged between January-June 2020. We subdivided ACT patients into bleeders and non-bleeders; we collected length of stay, mortality and clinical findings to identify predictors of bleeding. Patients taking prophylactic anticoagulation were excluded.
Results: We enrolled 511 patients (age 74.6±14.6 years), 193 (37.8%) undergoing ACT. Hospitalization for ACT-related bleeding was 6.2%. Bleeders (32/193, 16.6%) had longer hospital stays (16.0±0.6 days vs. 9.9±7.4 days, p 0.01), higher mortality rate (15.6% vs. 5.6%, p 0.04) vs. non-bleeders. Most bleeders initiated ACT within 90 days (OR 2.22, 95% CI 1.02-4.79, p 0.04), had higher CRP values (76.2±75.6 vs. 45.9±76.3 mg/L, p 0.001) and active cancer (OR 3.79, CI 1.72-8.82, p 0.002). LMWH associated with higher bleeding risk vs. DOACs and VKAs [OR 7.50 (2.86-19.68; p 0.0001) and OR 6.36 (2.13-19.03; p 0.001), respectively]. At multivariate analysis, concomitant LMWH and antiplatelet therapy were independent risk factors for ACT-related bleeding. Major bleedings occurred in 47% of patients, clinically relevant non-major bleedings in 34%. Bleeding prompted hospitalization in 65% of cases.
Conclusions: In Internal Medicine wards ACT use and ACT-related bleeding complications were significant. LMWH was a risk factor for bleeding; unclear whether it stems from comorbidities or the drug itself.
To cite this abstract in AMA style:Sartori MT, Boscaro F, Bozzolin A, Zurlo C, Fabris F. Anticoagulant Therapy and Related Bleeding Complications in Internal Medicine Wards [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/anticoagulant-therapy-and-related-bleeding-complications-in-internal-medicine-wards/. Accessed September 29, 2023.
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