Abstract Number: OC 61.1
Meeting: ISTH 2022 Congress
Background: Assessing bleeding risk in recently discharged medical patients is essential in decisions regarding venous thrombosis prophylaxis. Studies assessing post-discharge bleeding risk in this population of patients are lacking. To appropriately risk stratify people for post-discharge venous thrombosis prophylaxis, bleeding risk needs to be better understood.
Aims: To quantify the risk of and risk factors for bleeding after medical hospital discharge.
Methods: We followed all primary care patients aged ≥18 years at the University of Vermont Medical Center’s primary care clinics from July 2010 to September 2019. We applied validated computable phenotypes to electronic health record data and identified post-discharge (PD) bleeding events that required re-hospitalization within 90 days of the index hospital discharge. We report age and sex-adjusted odds ratios (OR) for putative bleeding risk factors.
Results: Between 2010-2019, there were a total of 14,266 medical hospitalizations and 1216 PD-bleeding events requiring re-admission. The bleeding rate for patients who did not have any medical hospitalizations in the past 90 days was 2.9 per 1000-person years compared to 98.9 per 1000 person-years for PD-bleeding up to 90 days after discharge. History of cancer, liver disease, renal failure, heart disease and bleeding disorder were associated with increased risk of PD-bleeding. Patients with anemia and thrombocytopenia or elevated creatinine at the time of discharge were also at increased risk for bleeding. The highest OR (6.2) was observed in patients who presented with bleeding at the time of the index admission (Table 1).
Conclusion(s): Bleeding requiring re-hospitalization is common after discharge from medical hospitalizations. There are easily identifiable, common, and strong risk factors for post-discharge bleeding. Development of risk assessment models for post-discharge bleeding may help guide patient care and is the focus of ongoing research.
To cite this abstract in AMA style:Gergi M, Wilkinson K, Sparks A, Al-Samkari H, Smith N, Roetker N, Plante T, Cushman M, Repp A, Holmes C, Zakai N. Risk factors for bleeding after recent medical hospitalization: The Medical Inpatient Thrombosis and Hemostasis Study (MITH) [abstract]. https://abstracts.isth.org/abstract/risk-factors-for-bleeding-after-recent-medical-hospitalization-the-medical-inpatient-thrombosis-and-hemostasis-study-mith/. Accessed March 4, 2024.
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