Study on incidence of bleeding in hospitalized patients after antithrombotic therapy at a tertiary care hospital

• Published in: Journal of the Association of Physicians of India Vol. 61; no. 2; pp. 110 - 113
• Main Authors: Prudhvi, K, Rao, V Daya Sagar, Jain, R K, Jiwani, P A, Padmanabhan, T N C, Ravikanth, G, Srinath, V S, Tavva, N V R Praveen Kumar
• Format: Journal Article
• Language: English
• Published: India 01.02.2013
• Subjects: Adult; Aged; Anticoagulants - adverse effects; Cohort Studies; Drug Therapy, Combination - adverse effects; Epistaxis - chemically induced; Female; Fibrinolytic Agents - adverse effects; Gastrointestinal Hemorrhage - chemically induced; Hematuria - chemically induced; Hemoptysis - chemically induced; Hemorrhage - chemically induced; Humans; Intracranial Hemorrhages - chemically induced; Linear Models; Male; Middle Aged; Oral Hemorrhage - chemically induced; Platelet Aggregation Inhibitors - adverse effects; Prospective Studies; Risk Assessment; Risk Factors; Severity of Illness Index; Tertiary Care Centers
• ISSN: 0004-5772

To monitor the different antithrombotic drug combinations, determine the incidence, magnitude of bleeding and the association of HAS-BLED risk scoring schema with the magnitude of bleeding as defined using TIMI bleeding criteria. A prospective observational study in a cohort of patients for a period of 8 months, at one of the tertiary care center-Krishna Institute of Medical Sciences, Hyderabad, was conducted. Consecutive patients were enrolled and followed from the date of admission till the adverse events are perceived/date of discharge. Pearson Correlation Statistics (Fisher's z Transformation) is applied to assess the association between HAS-BLED risk factors and the total risk score with bleeding criteria. A total of 400 cases were collected during the 8-month study period, of which 372 satisfied the inclusion criteria. Among them 34 (9.1%) bleeding cases were reported with mean (+/- SD) age of 57.8 (+/- 14.19) years. Bleeding occurred mostly in males 79.4% and a HAS-BLED Score of > or = 3 has been observed in 67.6% (n = 23) patients out of 34 bled patients. Two antiplatelets + One anticoagulant is the most common combination which caused bleeding in 41.2% (n = 14). Stroke history, bleeding predisposition, labile INR's are the HAS-BLED risk factors which are significant (< 0.05) with the TIMI Bleeding Criteria. There was a linear correlation between the HAS-BLED risk score and the TIMI bleeding criteria-higher the risk score the more frequent is the incidence of major bleeding. A HAS-BLED risk score of > or = 3 is associated with TIMI major bleeding.