Rydberg et al reported risk factors for severe bleeding in a patient receiving warfarin. These can help to identify a patient who may benefit from an intervention to reduce this risk. The authors are from Karolinska Institute and University of Copenhagen.
Patient selection: therapy with warfarin
Risk factors with greater hazard:
(1) history of prior bleeding (aHR 1.85)
(2) renal failure (aHR 1.82)
(3) alcohol dependency (aHR 1.79)
(4) age >= 60 years of age (aHR 1.67 if 60-69; 2.19 if 70-79; 2.88 if >= 80)
Other factors that may contribute:
(1) hypertension (aHR 1.22)
(2) diabetes (aHR 1.16)
(3) peripheral vascular disease (aHR 1.28)
(4) congestive heart failure (aHR 1.19)
(5) liver failure (aHR 1.43)
(6) COPD (aHR 1.19)
(7) cancer (aHR 1.33)
(8) therapy with antiplatelet drug other than low-dose aspirin (aHR 1.17)
(9) platelet or coagulation disorder (aHR 1.13)
(10) systemic corticosterids (aHR 1.20)
(11) male sex (aHR 1.18)
where:
• Concurrent therapy with low-dose aspirin was not a significant factor in the study.
• Excessive warfarin dosing is not listed.
