Risk of Major Bleeding Associated with Aspirin Use in Non-Surgical Critically Ill Patients Receiving Therapeutic Anticoagulation
| Autor: | Madeline Q. Johnson, Kimberly D. Evans, Andrew C. Hanson, Yosuf W. Subat, Hamza Rayes, Matthew A. Warner, Timothy J. Weister, Ognjen Gajic, Phillip J. Schulte, Vrinda Trivedi |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Critical Illness New York Hemorrhage Critical Care and Intensive Care Medicine Article Cohort Studies 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Concomitant Therapy medicine Electronic Health Records Humans Stroke Aged Retrospective Studies Aged 80 and over Aspirin business.industry Critically ill Incidence (epidemiology) Incidence Anticoagulants 030208 emergency & critical care medicine Retrospective cohort study Middle Aged medicine.disease Intensive Care Units 030228 respiratory system Concomitant Drug Therapy Combination Female business Major bleeding Platelet Aggregation Inhibitors medicine.drug |
| Zdroj: | J Crit Care |
| Popis: | Background We aimed to evaluate the risk of major bleeding in non-surgical critically ill patients who received aspirin in conjunction with therapeutic anticoagulation (concomitant therapy) compared to those who received therapeutic anticoagulation alone. Methods This is a retrospective cohort study of critically ill patients initiated on therapeutic anticoagulation at a large academic medical center from 2007 to 2016. The exposure of interest was aspirin therapy during anticoagulation. The primary outcome was the incidence of major bleeding during hospitalization. Secondary outcomes included in-hospital mortality, hospital free days, and new myocardial infarction or stroke. Results 5507 (73.2%) patients received anticoagulation alone and 2014 (26.8%) received concomitant therapy; major bleeding occurred in 19.0% and 22.2%, respectively. There was no increased risk of major bleeding [OR 1.10 (95% CI: 0.93–1.30); p = .27] or mortality [OR 0.93 (95% CI: 0.77–1.11); p = .43] with concomitant therapy. Patients receiving concomitant therapy had fewer hospital-free days (mean decrease of 0.73 [1.36, 0.09]; p = .03) and were more likely to experience new myocardial infarction or stroke [OR 2.61 (95% CI: 1.72–3.98); p Conclusions In non-surgical critically ill patients receiving therapeutic anticoagulation, concomitant use of aspirin was not associated with an increased risk of bleeding or in-hospital mortality. |
| Databáze: | OpenAIRE |
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