Major bleeding in outpatients treated with warfarin: incidence and prediction by factors known at the start of outpatient therapy

摘要: Purpose To determine the incidence of major bleeding in outpatients treated with warfarin and to identify predictive factors known at start therapy. Patients Methods The records 565 patients starting outpatient therapy upon discharge from a university hospital were reviewed. Follow-up information was obtained for 562 (99.5%). Bleeding classified as or minor using explicit criteria. cumulative estimated by means survival analysis. Independent risk identified Cox regression analysis 375 randomly chosen patients; they tested remaining 187 patients. Results Major occurred 65 (12%) fatal 10 (2%). incidences one, 12, 48 months 3%, 11%, 22%, respectively. monthly decreased over time, 3% during first month 0.3% per after year Five independent bleeding—age years greater, history stroke, gastrointestinal bleeding, serious comorbid condition (recent myocardial infarction, renal insufficiency, severe anemia), atrial fibrillation—predicted testing group; 2% 57 low-risk patients, 17% 110 middle-risk 63% 20 high-risk Conclusions These findings provide quantitative basis evaluating individual warfarin. Whether can be reduced without reducing benefit remains determined.