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


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Department of Hospital and Clinical Pharmacy, Bharat Institute of Pharmacy, Hyderabad 501510, Andhra Pradesh.
K
K
Prudhvi
Krishna Institute of Medical Sciences, Hyderabad.
V Daya Sagar
VD
Rao
Krishna Institute of Medical Sciences, Hyderabad.
R K
RK
Jain
Krishna Institute of Medical Sciences, Hyderabad.
P A
PA
Jiwani
Krishna Institute of Medical Sciences, Hyderabad.
T N C
TN
Padmanabhan
Krishna Institute of Medical Sciences, Hyderabad.
G
G
Ravikanth
Krishna Institute of Medical Sciences, Hyderabad 500003, Andhra Pradesh.
V S
VS
Srinath
Department of Pharm D, Bharat Institute of Pharmacy, Hyderabad 501 510, Andhra Pradesh.
N V R Praveen Kumar
NV
Tavva
D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects*; D015331:Cohort Studies; D004359:Drug Therapy, Combination / Q000009:adverse effects; D004844:Epistaxis / Q000139:chemically induced; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects*; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced; D006417:Hematuria / Q000139:chemically induced; D006469:Hemoptysis / Q000139:chemically induced; D006470:Hemorrhage / Q000139:chemically induced*; D006801:Humans; D020300:Intracranial Hemorrhages / Q000139:chemically induced; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D006472:Oral Hemorrhage / Q000139:chemically induced; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D062606:Tertiary Care Centers
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors