Real-World Data on Characteristics and Management of Community Patients Receiving Anticoagulation Therapy Who Presented with Acute Bleeding to the Emergency Department at a Regional Australian Hospital: A Prospective Observational Study.

摘要: Objective To study patients receiving anticoagulants with or without antiplatelet therapy presenting at a regional Australian hospital bleeding. The main aims are to explore: (1) patients' characteristics and management provided; (2) association between the type of anticoagulant agent used requirement reversal; (3) length stay (LoS) in conjunction bleeding episode management. Methods A prospective cross-sectional review medical records all who presented tertiary referral centre while anticoagulation January 2016 June 2018. Data included: patients, demographics, investigations (kidney liver function tests, coagulation profile, FBC), LoS, site, reason for therapy, provided. analysis included descriptive statistics, χ2 association, regression models. Results Among 144 eligible 75 (52.1%) were male, mean age was 76 years (SD=11.1). Gastrointestinal tract most common (n=48, 33.3%), followed by epistaxis (n=32, 22.2%). Atrial fibrillation commonest (n=65, 45.1%). Warfarin commonly (n=74, 51.4%), aspirin (n=29, 20.1%), rivaroxaban (n=26, 18.1%), apixaban (n=12, 8.3%). majority had increased blood urea nitrogen (n=67, 46.5%), 58 (40.3%) an elevated serum creatinine level, 59 (41.0%) mild reduction eGFR. Thirty-five warfarinised (47.3%) INR above their condition's target range despite normal function. Severe anaemia (Hb<80g/L) reported 88 (61.1%). DOACs associated reduced likelihood reversal (B= -1.7, P=<.001), shorter LoS -4.1, P=.046) when compared warfarin, LMWH, therapy. Conclusion use among acute bleeding, many exceeded condition. than which might support broader application into community practice.