Bleeding complications of oral anticoagulant treatment: An inception-cohort, prospective collaborative study (ISCOAT)
Bleeding complications of oral anticoagulant treatment: An inception-cohort, prospective collaborative study (ISCOAT)
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DOI：
10.1016/s0140-6736(96)01109-9
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发表时间：
1996-08-17
期刊：
影响因子：
168.9
通讯作者：
Musolesi, S
中科院分区：
文献类型：
--
作者：
Palareti, G;Leali, N;Musolesi, S
出血是使用口服抗凝剂预防和治疗血栓栓塞并发症的最严重并发症。我们研究了出血并发症的频率在门诊常规治疗抗凝clinics.Methods在一个前瞻性队列从34个意大利抗凝clinics. Methods，2745例连续患者进行了研究，从他们开始口服抗凝（华法林在64%，醋硝香豆素在休息）。71%的患者的目标抗凝强度较低（国际标准化比值[INR]小于或等于2.8），71%的患者的目标抗凝强度较高（小于或等于2.8）。剩下的我们记录了人口统计学细节和治疗的主要适应症，每3-4个月记录一次INR和结局事件。这些事件包括所有并发症（出血、血栓形成、其他），尽管仅包括用药过量。此处报告出血事件和死亡。我们将出血分为主要和次要类别。结果43%的患者是女性。近五分之三的患者年龄在60-79岁之间; 8%的患者超过80岁。治疗的主要适应症是静脉血栓形成（33%），其次是非缺血性心脏病（17%）。平均随访时间为267天。在2011患者年的随访中，发生了153例出血并发症（7.6/100患者年）。5例为致死性（所有脑出血，0.25/100患者-年），23例为严重出血（1.1），125例为轻微出血（6.2）。不同性别、香豆素类型、入组中心规模和目标INR之间的事件发生率相似。老年患者的发生率更高：70岁或以上患者为10.5/100患者-年，70岁以下患者为6.0/100患者-年（相对风险1.75，95%CI 1.29-2.39，p
Background Bleeding is the most serious complication of the use of oral anticoagulation in the prevention and treatment of thromoboembolic complications. We studied the frequency of bleeding complications in outpatients treated routinely in anticoagulation clinics.Methods In a prospective cohort from thirty-four Italian anticoagulation clinics, 2745 consecutive patients were studied from the start of their oral anticoagulation (warfarin in 64%, acenocourmarol in the rest). The target anticoagulation-intensity was low (international normalised ratio [INR] less than or equal to 2.8) in 71% of the patients and high (less than or equal to 2.8) in. the remainder. We recorded demographic details and the main indication for treatment and, every 3-4 months, INR and outcome events. Such events included all complications (bleeding, thrombosis, other), although only overdosing. bleeding events are reported here, and deaths. We divided bleeding into major and minor categories.Findings 43% of the patients were women. Nearly three-fifths of the patients were aged 60-79; 8% were over 80. The main indication for treatment was venous thrombolism (33%), followed by non-ischaemic heart disease (17%). Mean follow-up was 267 days. Over 2011 patient-years of follow-up, 153 bleeding complications occurred (7.6 per 100 patient-years). 5 were fatal (all cerebral haemorrhages, 0.25 per 100 patient-years), 23 were major (1.1), and 125 were minor (6.2). The rate of events was similar between sexes, coumarin type, size of enrolling centre, and target INR. The rate was higher in older patients: 10.5 per 100 patient-years in those aged 70 or over, 6.0 in those aged under 70 (relative risk 1.75, 95% CI 1.29-2.39, p