A bleeding risk index for estimating the probability of major bleeding in hospitalized patients starting anticoagulant therapy
| Autor: | Edward McGuire, Miriam W. Rosenblatt, C. Seth Landefeld |
|---|---|
| Rok vydání: | 1990 |
| Předmět: |
Male
medicine.medical_specialty Hospitalized patients Hemorrhage Cohort Studies Risk Factors Internal medicine Risk index medicine Humans In patient Prospective Studies Aged Ohio Probability Proportional Hazards Models Retrospective Studies Aged 80 and over medicine.diagnostic_test business.industry Anticoagulants Reproducibility of Results General Medicine Middle Aged INCEPTION COHORT Surgery Hospitalization Anticoagulant therapy ROC Curve Multivariate Analysis Female Liver dysfunction business Major bleeding Partial thromboplastin time Boston |
| Zdroj: | The American journal of medicine. 89(5) |
| ISSN: | 0002-9343 |
| Popis: | purpose: To construct and test prospectively a bleeding risk index for estimating the probability of major bleeding in hospitalized patients starting long-term anticoagulant therapy. patients and methods: In an inception cohort of 617 patients starting long-term anticoagulant therapy in one hospital, data were gathered retrospectively and bleeding was classified using reliable explicit criteria. We constructed a bleeding risk index by identifying and weighting independent predictors of major bleeding using a multivariate proportional-hazards model. The bleeding risk index was tested in 394 other patients prospectively identified in a second hospital. The index was compared to physicians' predictions. results: Major bleeding developed before discharge in 61 of all 1,011 patients (6%). The bleeding risk index included four independent risk factors for major in-hospital bleeding: the number of specific comorbid conditions; heparin use in patients aged 60 years or older; maximal prothrombin or partial thromboplastin time 2.0 or more times control; liver dysfunction worsening during therapy. In the testing group, the index predicted major bleeding, which occurred in 3% of 235 low-risk patients, 16% of 96 middle-risk patients, and 19% of 63 high-risk patients (p |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|