Extracranial anticoagulant related bleedings admitted to intensive care units: a French multicenter retrospective study
Authors' conclusion
Anticoagulant-related extracranial bleeding requiring ICU admission is a serious complication responsible for organ failure and significant mortality. Its incidence is rising. The therapeutic management is suboptimal
Study context
- Population
- Adults (>18 years) admitted to 5 French intensive care units (ICUs) for extracranial bleeding while receiving therapeutic anticoagulation, January 2007–December 2018
- Participants
- 486 adults · 5 French ICUs
- Exposure
- Vitamin K antagonists (VKA) vs Heparins vs direct oral anticoagulants (DOAC)
- Outcome
- Incidence of ICU admission for anticoagulant-related extracranial bleeding, and ICU mortality
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
Incidence of ICU admission for anticoagulant-related bleeding, 2007
3.2/1000 admissions
Incidence of ICU admission for anticoagulant-related bleeding, 2018
5.8/1000
ICU mortality
27%
Independently associated with mortality (multivariate): chronic hypertension, need for vasopressors, impaired consciousness, hyperlactatemia, prolonged aPTT > 1.2
5 factors
Observational data: associations, not effects.
Further findings
Organ failure at admission
- SOFA score
- 7 ± 4
- Vasopressors
- 31.5%
- Invasive mechanical ventilation
- 34%
Adherence to guidelines for specific treatment of anticoagulant-related bleeding
- Generally low
Factors independently associated with mortality (multivariate analysis)
- Chronic hypertension, need for vasopressors, impaired consciousness, hyperlactatemia, prolonged aPTT > 1.2
Original publication
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