Incidence and predictors of severe bleeding during warfarin treatment.

摘要: Background Optimal warfarin prescription requires correct, individualized assessment of the warfarin-related bleeding risk, which randomised controlled trials may underestimate . Observational studies have reported a range risks that differ 40-fold. This variation be caused by time trends, in definition and study subject selection. We investigated incidence of, risk factors for severe un-selected warfarin-treated patients from Sweden. Methods Between 2001 2005, 40 centres recruited warfarin-naive commencing therapy followed them prospectively with continuous registration clinical data. The primary outcome was bleeding, according to WHO universal adverse drug reactions. influence potential means Cox proportional-hazards model. Result A total 1523 contributed 1276 warfarin-exposed patient-years. first-time 2.3 per 100 patient-years (95% confidence interval 1.4 3.1). Male sex use drugs potentially interacting were only independent hazard ratios 2.8 2.3, respectively. Age, target International Normalized Ratio (INR), spent outside INR range, dose requirement not significantly associated risk. Conclusions large naturalistic, prospective cohort users lower than some previous reports. gender an predictor as receipt warfarin-interacting medications at onset anticoagulation therapy. Further are required evaluate effect these findings on quality current risk-benefit analysis involved prescription.