Physical activity and risk of bleeding in elderly patients taking anticoagulants
Physical activity and risk of bleeding in elderly patients taking anticoagulants
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DOI：
10.1111/jth.12793
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发表时间：
2015-02-01
影响因子：
10.4
通讯作者：
Aujesky, D.
中科院分区：
文献类型：
--
作者：
Frey, P. M.;Mean, M.;Aujesky, D.
BackgroundAlthough the possibility of bleeding during anticoagulant treatment may limit patients from taking part in physical activity, the association between physical activity and anticoagulation-related bleeding is uncertain.ObjectivesTo determine whether physical activity is associated with bleeding in elderly patients taking anticoagulants.Patients/MethodsIn a prospective multicenter cohort study of 988 patients aged 65years receiving anticoagulants for venous thromboembolism, we assessed patients' self-reported physical activity level. The primary outcome was the time to a first major bleeding, defined as fatal bleeding, symptomatic bleeding in a critical site, or bleeding causing a fall in hemoglobin or leading to transfusions. The secondary outcome was the time to a first clinically relevant non-major bleeding. We examined the association between physical activity level and time to a first bleeding by using competing risk regression, accounting for death as a competing event. We adjusted for known bleeding risk factors and anticoagulation as a time-varying covariate.ResultsDuring a mean follow-up of 22months, patients with a low, moderate, and high physical activity level had an incidence of major bleeding of 11.6, 6.3, and 3.1 events per 100 patient-years and an incidence of clinically relevant non-major bleeding of 14.0, 10.3, and 7.7 events per 100 patient-years, respectively. A high physical activity level was significantly associated with a lower risk of major bleeding (adjusted sub-hazard ratio 0.40, 95% confidence interval 0.22-0.72). There was no association between physical activity and non-major bleeding.ConclusionsA high level of physical activity is associated with a decreased risk of major bleeding in elderly patients receiving anticoagulant therapy.
