Risk of falls and major bleeds in patients on oral anticoagulation therapy.

Détails

ID Serval
serval:BIB_A9FF269EB3B9
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Risk of falls and major bleeds in patients on oral anticoagulation therapy.
Périodique
American Journal of Medicine
Auteur(s)
Donzé J., Clair C., Hug B., Rodondi N., Waeber G., Cornuz J., Aujesky D.
ISSN
1555-7162 (Electronic)
ISSN-L
0002-9343
Statut éditorial
Publié
Date de publication
2012
Volume
125
Numéro
8
Pages
773-778
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
BACKGROUND: The risk of falls is the most commonly cited reason for not providing oral anticoagulation, although the risk of bleeding associated with falls on oral anticoagulants is still debated. We aimed to evaluate whether patients on oral anticoagulation with high falls risk have an increased risk of major bleeding.
METHODS: We prospectively studied consecutive adult medical patients who were discharged on oral anticoagulants. The outcome was the time to a first major bleed within a 12-month follow-up period adjusted for age, sex, alcohol abuse, number of drugs, concomitant treatment with antiplatelet agents, and history of stroke or transient ischemic attack.
RESULTS: Among the 515 enrolled patients, 35 patients had a first major bleed during follow-up (incidence rate: 7.5 per 100 patient-years). Overall, 308 patients (59.8%) were at high risk of falls, and these patients had a nonsignificantly higher crude incidence rate of major bleeding than patients at low risk of falls (8.0 vs 6.8 per 100 patient-years, P=.64). In multivariate analysis, a high falls risk was not statistically significantly associated with the risk of a major bleed (hazard ratio 1.09; 95% confidence interval, 0.54-2.21). Overall, only 3 major bleeds occurred directly after a fall (incidence rate: 0.6 per 100 patient-years).
CONCLUSIONS: In this prospective cohort, patients on oral anticoagulants at high risk of falls did not have a significantly increased risk of major bleeds. These findings suggest that being at risk of falls is not a valid reason to avoid oral anticoagulants in medical patients.
Mots-clé
Accidental Falls, Administration, Oral, Aged, Aged, 80 and over, Anticoagulants/administration & dosage, Anticoagulants/adverse effects, Atrial Fibrillation/drug therapy, Atrial Fibrillation/epidemiology, Comorbidity, Cross-Sectional Studies, Drug Therapy, Combination, Female, Follow-Up Studies, Heart Valve Prosthesis Implantation, Hemorrhage/chemically induced, Hemorrhage/epidemiology, Humans, Male, Middle Aged, Platelet Aggregation Inhibitors/administration & dosage, Proportional Hazards Models, Prospective Studies, Risk Assessment/statistics & numerical data, Thromboembolism/drug therapy, Thromboembolism/epidemiology
Pubmed
Web of science
Création de la notice
12/09/2012 10:31
Dernière modification de la notice
20/08/2019 15:14
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