Table 3.20-5. Risk of bleeding during anticoagulant therapy

Factors associated with bleeding during anticoagulant therapy:

– Older age (>65 years and particularly >75 years)a

– Previous bleeding (particularly if the cause was not correctable)

– Cancer (particularly if metastatic or highly vascular)

– Renal insufficiency

– Liver failure

– Diabetes mellitus

– Previous stroke

– Thrombocytopenia

– Anemia

– Concomitant antiplatelet therapy

– Recent surgery

– Frequent falls

– Alcohol abuse

– Reduced functional capacity

– Poor control of VKA therapy

With an increase in the severity of individual factors and with an increase in the number of factors present, the risk of bleeding is expected to increase (both at baseline and while on anticoagulants).

a Young (eg, <65 years) healthy patients with good VKA control will have a low risk of major bleeding (≤1% per patient-year), those with less severe factors have an intermediate risk, and elderly patients with severe or multiple factors are at high risk for major bleeding (>4% per patient-year).

Based on Blood. 2014;123(12):1794-801.

VKA, vitamin K antagonist.