Hematology and Oncology Book

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Major Bleeding Risk With Anticoagulants

Aka: Major Bleeding Risk With Anticoagulants
  1. Risk Factors: Fragility (1 point for each unless otherwise noted)
    1. Advanced Age (1 point if age>65, 2 points if age>75 years)
    2. Comorbidity and reduced functional capacity
    3. Frequent Falls
    4. Alcohol Abuse
    5. Recent surgery
  2. Risk Factors: Comorbidity (1 point for each unless otherwise noted)
    1. Cancer (1 point or 2 points if metastatic)
    2. Diabetes Mellitus
    3. Liver Failure
    4. Renal Failure
    5. Prior Cerebrovascular Accident
  3. Risk Factor: Bleeding Disorder (1 point for each unless otherwise noted)
    1. Anemia
    2. Antiplatelet Therapy
    3. Thrombocytopenia
    4. Poor Anticoagulant control
    5. Prior bleeding problems
  4. Interpretation: Absolute Bleeding Risk (based on total risk points from above)
    1. Low risk (0 risk factors)
      1. Initial risk <3 months: 1.6%
      2. Later risk >3 months: 0.8%
    2. Moderate risk (1 risk factor)
      1. Initial risk <3 months: 3.2%
      2. Later risk >3 months: 1.6%
    3. High risk (2 or more risk factors)
      1. Initial risk <3 months: 12.8%
      2. Later risk >3 months: 6.5%
  5. References
    1. Kearon (2012) Chest141(2 suppl):e419S-494S [PubMed]

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