title: Clinical Features and Outcomes of Diffuse Alveolar Hemorrhage During Antithrombotic Therapy: A Retrospective Cohort Study.
abstract: 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.
  
  
  
  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.
  
  
  
  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).
  
  
  
  Antithrombotic therapies had no effect on the 90-day mortality of DAH patients.
authors.affiliation: Department of Respiratory Medicine, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminami-cho, Chuo-ku, Kobe, Hyogo, 650-0047, Japan. takehiro-otoshi19850902@gmail.com.
authors.forename: T
authors.initials: T
authors.lastname: Otoshi
authors.affiliation: Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, Amagasaki, Hyogo, 660-8550, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kataoka
authors.affiliation: Department of Respiratory Medicine, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminami-cho, Chuo-ku, Kobe, Hyogo, 650-0047, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Nakagawa
authors.affiliation: Department of Respiratory Medicine, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminami-cho, Chuo-ku, Kobe, Hyogo, 650-0047, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Otsuka
authors.affiliation: Department of Respiratory Medicine, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminami-cho, Chuo-ku, Kobe, Hyogo, 650-0047, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Tomii
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000009:adverse effects; D000077407:Cilostazol; D000077144:Clopidogrel; D003240:Connective Tissue Diseases / Q000150:complications; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects*; D006333:Heart Failure / Q000150:complications; D006470:Hemorrhage / Q000150:complications / Q000209:etiology*; D006801:Humans; D007239:Infections / Q000209:etiology; D008171:Lung Diseases / Q000150:complications / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D011014:Pneumonia / Q000150:complications; D011650:Pulmonary Alveoli; D012189:Retrospective Studies; D015996:Survival Rate; D013777:Tetrazoles / Q000009:adverse effects; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives; D014657:Vasculitis / Q000150:complications; D014859:Warfarin / Q000009:adverse effects
chemical_list: D005343:Fibrinolytic Agents; D013777:Tetrazoles; D014859:Warfarin; D000077144:Clopidogrel; D000077407:Cilostazol; D013988:Ticlopidine; D001241:Aspirin
keywords: Acute respiratory failure; Antithrombotic therapy; Critical care medicine; Diffuse alveolar hemorrhage