Bleeding complications from the direct oral anticoagulants

BMC Hematology

Research Article

Yulia Lin¹  Christine Cserti-Gazdewich²  Nadine Shehata³  Katerina Pavenski⁴  Michelle Sholzberg⁵ 

[1] Department of Clinical Pathology, Sunnybrook Health Sciences Centre; and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada;Department of Laboratory Medicine and Pathobiology, University Health Network, University of Toronto, Toronto, ON, Canada;Departments of Medicine and Laboratory Medicine and Pathobiology, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada;Division of Hematology, Department of Medicine and Department of Laboratory Medicine and Pathobiology St. Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada;Division of Hematology, Department of Medicine and Department of Laboratory Medicine and Pathobiology, St. Michael’s Hospital, University of Toronto, 30 Bond Street, Room 2-007G Core Lab, Carter Wing, M5B-1 W8, Toronto, ON, Canada;

关键词: Anticoagulants;    Blood transfusion;    Dabigatran;    Hemorrhage;    Rivaroxaban;   

DOI  :  10.1186/s12878-015-0039-z

 received in 2015-07-01, accepted in 2015-12-05,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundDirect oral anticoagulants (DOACs) are now standard of care for the management of thromboembolic risk. A prevalent issue of concern is how to manage direct oral anticoagulant (DOAC)-associated bleeding for which there is no specific antidote available for clinical use. We conducted a retrospective case series to describe the Toronto, Canada multicenter experience with bleeding from dabigatran or rivaroxaban.MethodsRetrospective chart review of DOAC bleeding necessitating referral to hematology and/or transfusion medicine services at five large University of Toronto affiliated academic hospitals from January 2011 to December 2013.ResultsTwenty-six patients with DOAC bleeding were reviewed; 42 % bleeds intracranial and 50 %, gastrointestinal. All patients had at least one risk factor associated with DOAC bleeding reported in previous studies. Inconsistent bleed management strategies were evident. Median length of hospital stay was 11 days (1–90). Five thromboembolic events occurred after transfusion based-hemostatic therapy and there were six deaths.ConclusionsManagement of DOAC bleeding is variable. Clinical trial data regarding DOAC reversal is needed to facilitate optimization and standardization of bleeding treatment algorithms.

【 授权许可】

CC BY   
© Sholzberg et al. 2015