Clinical Features and Outcomes of Diffuse Alveolar Hemorrhage During Antithrombotic Therapy: A Retrospective Cohort Study

• Published in: Lung Vol. 194; no. 3; pp. 475 - 481
• Main Authors: Otoshi, T., Kataoka, Y., Nakagawa, A., Otsuka, K., Tomii, K.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.06.2016; Springer; Springer Nature B.V
• Subjects: Adult; Adult respiratory distress syndrome; Aged; Aged, 80 and over; Aspirin - adverse effects; Causes of; Complications and side effects; Connective Tissue Diseases - complications; Drug therapy; Female; Fibrinolytic agents; Fibrinolytic Agents - adverse effects; Health aspects; Heart Failure - complications; Hemorrhage; Hemorrhage - complications; Hemorrhage - etiology; Humans; Infection - etiology; Lung diseases; Lung Diseases - complications; Lung Diseases - etiology; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasms - complications; Pneumology/Respiratory System; Pneumonia - complications; Pulmonary Alveoli; Retrospective Studies; Risk factors; Survival Rate; Tetrazoles - adverse effects; Ticlopidine - adverse effects; Ticlopidine - analogs & derivatives; Vasculitis - complications; Warfarin - adverse effects; Acute respiratory failure; Diffuse alveolar hemorrhage; Critical care medicine; Antithrombotic therapy
• ISSN: 0341-2040; 1432-1750
• DOI: 10.1007/s00408-016-9873-4

Purpose Antithrombotic therapy could trigger diffuse alveolar hemorrhage (DAH), and there are several case reports of DAH that occurred during antithrombotic therapy (DAH-AT). However, little is known about the clinical features and outcomes of DAH-AT. The purpose of this study was to clarify the features and mortality of DAH-AT. Methods 76 consecutive patients with DAH who were admitted to our hospital between January 2003 and April 2014 were retrospectively reviewed to identify the clinical features and outcomes of DAH-AT. The primary outcome was 90-day mortality. Results Of the 76 patients with DAH, 39 patients (51 %) had DAH-AT, and 37 patients (49 %) had DAH that occurred with no antithrombotic therapy (DAH-NAT). Of the patients with DAH-AT, 25 (64 %) were taking aspirin, 14 (36 %) were taking warfarin, 5 (13 %) were taking clopidogrel sulfate, and 4 (10 %) were taking cilostazol. Pre-existing cardiac disease was present in 23 (59 %) DAH-AT cases and 5 (14 %) DAH-NAT cases. Logistic regression analysis was used to assess the effect of antithrombotic therapy on the mortality of DAH patients, and no significant difference in survival was seen with antithrombotic therapy (OR 1.18, 95 % CI 0.38–3.78). Conclusions Antithrombotic therapies had no effect on the 90-day mortality of DAH patients.