Back to Search
Start Over
Management and outcome of major bleeding in patients receiving vitamin K antagonists for venous thromboembolism
- Source :
- Thrombosis Research, 171, 74-80. PERGAMON-ELSEVIER SCIENCE LTD
- Publication Year :
- 2018
-
Abstract
- Background: The optimal management of major bleeding in patients receiving vitamin K antagonists (VKA) for venous thromboembolism (VTE) is unclear.Methods: We used the RIETE (Registro Informatizado Enfermedad TromboEmbolica) registry to assess the management and 30-day outcomes after major bleeding in patients receiving VKA for VTE.Results: From January 2013 to December 2017, 267 of 18,416 patients (1.4%) receiving long-term VKA for VTE had a major bleeding (in the gastrointestinal tract 78, intracranial 72, hematoma 50, genitourinary 20, other 47). Overall, 151 patients (57%) received blood transfusion; 110 (41%) vitamin K; 37 (14%) fresh frozen plasma; 29 (11%) pro-haemostatic agents and 20 (7.5%) a vena cava filter. During the first 30 days, 59 patients (22%) died (41 died of bleeding) and 13 (4.9%) had a thrombosis. On multivariable analysis, patients with intracranial bleeding (hazard ratio [HR]: 4.58; 95% CI: 2.40-8.72) and those with renal insufficiency at baseline (HR: 2.73; 95% CI: 1.45-5.15) had an increased mortality risk, whereas those receiving vitamin K had a lower risk (HR: 0.47; 0.24-0.92). On the other hand, patients receiving fresh frozen plasma were at increased risk for thrombotic events (HR: 4.22; 95% CI: 1.25-14.3).Conclusions: Major bleeding in VTE patients receiving VKA carries a high mortality rate. Intracranial bleeding and renal insufficiency increased the risk. Fresh frozen plasma seems to increase this risk for recurrent VTE.
- Subjects :
- Male
medicine.medical_specialty
Blood transfusion
Vitamin K
PULMONARY-EMBOLISM
REVERSAL
medicine.medical_treatment
Hemorrhage
030204 cardiovascular system & hematology
Lower risk
Gastroenterology
Hemostatics
WARFARIN
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Humans
Blood Transfusion
030212 general & internal medicine
Renal Insufficiency
Aged
Retrospective Studies
Aged, 80 and over
RISK
PLASMA
business.industry
Hazard ratio
Warfarin
DABIGATRAN
Anticoagulants
Hematology
Venous Thromboembolism
Middle Aged
medicine.disease
Thrombosis
Prothrombin complex concentrate
Pulmonary embolism
Treatment Outcome
SAFETY
Female
Fresh frozen plasma
business
PROTHROMBIN COMPLEX CONCENTRATE
ANTICOAGULANT-THERAPY
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 00493848
- Volume :
- 171
- Database :
- OpenAIRE
- Journal :
- Thrombosis Research
- Accession number :
- edsair.doi.dedup.....d1149ea9b9865f78d604029507163d7a