title: Antithrombotic medication use and bleeding risk in medically ill patients after hospitalization.
abstract: BACKGROUND
  Hospitalized medically ill patients receiving antithrombotic medications experience increased risk of bleeding. We examined antithrombotic use, bleeding rates, and associated risk factors at 30 days post discharge.
  
  
  METHODS
  This retrospective database analysis included nonsurgical patients aged ≥40 years hospitalized for ≥2 days during 2005 to 2009. Previously cited, validated International Classification of Diseases, Ninth Revision, Clinical Modification codes for major bleeding were used to define clinically relevant bleeding.
  
  
  RESULTS
  Of the 327,578 patients, 9.1% received antithrombotic medications, of which 3.7% were anticoagulants. Rates of major and minor bleeding were 1.8% and 7.1%, respectively. Preindex gastroduodenal ulcer, thromboembolic stroke, blood dyscrasias, liver disease, and rehospitalization were the strongest predictors of major bleeding. Other risk factors included increasing age, male gender, and hospital stay of ≥3 days.
  
  
  CONCLUSIONS
  Careful consideration of these demonstrated bleed-associated comorbidities before initiating anticoagulation or combining antithrombotic medications in medically ill patients may improve strategies for prevention of postdischarge thromboembolism.
authors: 1Department of Outcomes Research, New Mexico Heart Institute, Albuquerque, NM, USA.
authors: Charles E
authors: CE
authors: Mahan
authors: Alex C
authors: AC
authors: Spyropoulos
authors: Maxine D
authors: MD
authors: Fisher
authors: Larry E
authors: LE
authors: Fields
authors: Roger M
authors: RM
authors: Mills
authors: Judith J
authors: JJ
authors: Stephenson
authors: An-Chen
authors: AC
authors: Fu
authors: Winslow
authors: W
authors: Klaskala
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000188:drug therapy
chemical_list: D000925:Anticoagulants
keywords: anticoagulants; antiplatelet; bleeding; drugs; thrombosis prophylaxis; venous thromboembolism