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Emergency admissions for major haemorrhage associated with direct oral anticoagulants
- Source :
- Thrombosis Research, Thrombosis Research, Elsevier, 2015, 136 (6), pp.1190-1194. ⟨10.1016/j.thromres.2015.10.036⟩, Thrombosis Research, 2015, 136 (6), pp.1190-1194. ⟨10.1016/j.thromres.2015.10.036⟩
- Publication Year :
- 2015
- Publisher :
- HAL CCSD, 2015.
-
Abstract
- Introduction To describe the population admitted in an emergency department of a teaching hospital for severe bleeding associated with direct oral anticoagulants (DOAC). Method During a three-year period (2012–2014) patients older than 16 years were prospectively identified by haemorrhagic symptoms from computerised requests. At least one of the following criteria defined major haemorrhage: haemorrhagic shock, unstable haemodynamic, need for transfusion or haemostatic procedure, or a life threatening location. Results Fifty four patients, 23 receiving dabigatran, 30 rivaroxaban and one apixaban were included, 2 in 2012, 35 in 2013 and 17 in 2014. Median age was 84 years (range 63–99) with a sex ratio of 1.16. Haemorrhagic complications were gastrointestinal (n = 27), intracranial (n = 12) or miscellaneous (n = 15). Indication of DOAC was stroke prevention in atrial fibrillation in 49 cases and deep vein thrombosis in 5 cases. Hospitalization was required for 45 patients (83%) with a mean length of stay of 8.5 days. Sixteen patients needed intensive care. Reversal therapy was prescribed in 11 patients. At 1 month, overall mortality was 24%, reaching 41.7% for intracranial haemorrhage. Among surviving patients, DOAC was stopped in 10 cases, continued in 17 patients and switched for other antithrombotic in 17 patients. Conclusion Our study contributes to the post marketing surveillance of major haemorrhagic complications associated with DOAC. It takes part to the knowledge about the course of this severe event in emergencies. Careful awareness in risk benefit assessment, especially in elderly, is needed.
- Subjects :
- Male
Pediatrics
medicine.medical_specialty
Gastrointestinal bleeding
Pyridones
Deep vein
[SDV]Life Sciences [q-bio]
Population
Administration, Oral
Hemorrhage
Dabigatran
Patient Admission
Rivaroxaban
Intensive care
Atrial Fibrillation
Medicine
Humans
Prospective Studies
education
Aged
Aged, 80 and over
Venous Thrombosis
education.field_of_study
Hemostasis
business.industry
Hemodynamics
Anticoagulants
Hematology
Emergency department
Middle Aged
medicine.disease
3. Good health
Stroke
medicine.anatomical_structure
Haemorrhage
Pyrazoles
Apixaban
Female
business
Emergency Service, Hospital
Gastrointestinal Hemorrhage
Intracranial Hemorrhages
medicine.drug
Direct oral anticoagulant
Subjects
Details
- Language :
- English
- ISSN :
- 00493848 and 18792472
- Database :
- OpenAIRE
- Journal :
- Thrombosis Research, Thrombosis Research, Elsevier, 2015, 136 (6), pp.1190-1194. ⟨10.1016/j.thromres.2015.10.036⟩, Thrombosis Research, 2015, 136 (6), pp.1190-1194. ⟨10.1016/j.thromres.2015.10.036⟩
- Accession number :
- edsair.doi.dedup.....1874e094797c079af4bad55e318a5197