ArticleJournal of general internal medicine2015
Polypharmacy is associated with an increased risk of bleeding in elderly patients with venous thromboembolism.
Article in Journal of general internal medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 75 citations in OpenAlex.
- Concurrent Use of Prescription Drugs and Herbal Medicinal Products in Older Adults: A Systematic Review.Drugs & aging · 2017Pooled it
- Polypharmacy and effects of apixaban versus warfarin in patients with atrial fibrillation: post hoc analysis of the ARISTOTLE trial.BMJ (Clinical research ed.) · 2016Trial
- Coagulation profiles and factor XIII activity in pediatric patients with severe motor and intellectual disability: a multicenter exploratory study.International journal of hematology · 2026Article
- Direct oral anticoagulants in cancer-associated venous thromboembolism: trial robustness and clinical trade-offs.Research and practice in thrombosis and haemostasis · 2026Article
- How does the addition of antiplatelet therapy to antithrombotic therapy in patients with atrial fibrillation and stable coronary artery disease affect outcomes? A meta-analysis of randomized controlled trials.Cardiovascular endocrinology & metabolism · 2025Review
- Clinical implication of anemia in older patients with dementia with lewy bodies.Aging clinical and experimental research · 2025Article
- Association between selective serotonin reuptake inhibitors use and blood transfusion risk in older adults after hip fracture: a cohort study.BMC geriatrics · 2024Observational
- Nonvitamin K Anticoagulants: Risk of Bleeding When Interacting With Other Medications: A Cohort Study From Medicare.Clinical cardiology · 2024Observational
- Management of Patients Treated with Direct Oral Anticoagulants in Clinical Practice and Challenging Scenarios.Journal of clinical medicine · 2023Review
- Trauma-related falls in an urban geriatric population: predictive risk factors for poorer clinical outcomes.Injury epidemiology · 2023Article
- Incidence and clinical impact of bleeding events in older patients with acute venous thromboembolism.Blood advances · 2023Article
- Polypharmacy, chronic kidney disease, and mortality among older adults: A prospective study of National Health and nutrition examination survey, 1999-2018.Frontiers in public health · 2023Article
- Drug-Drug Interactions of Direct Oral Anticoagulants (DOACs): From Pharmacological to Clinical Practice.Pharmaceutics · 2022Review
- Prevalence of potentially harmful multidrug interactions on medication lists of elderly ambulatory patients.BMC geriatrics · 2021Article
- Predicting the risk for major bleeding in elderly patients with venous thromboembolism using the Charlson index. Findings from the RIETE.Journal of thrombosis and thrombolysis · 2021Article
- Use of a 5-item modified Fragility Index for risk stratification in patients undergoing surgical management of proximal humerus fractures.JSES international · 2021Article
- Categorisation of Pharmaceutical Adverse Events Using the Japanese Adverse Drug Event Report Database: Characteristic Adverse Drug Events of the Elderly Treated with Polypharmacy.Drugs - real world outcomes · 2021Article
- Aspirin for prevention of colorectal cancer in the elderly: friend or foe?Annals of gastroenterology · 2021Review
- Polypharmacy, Adverse Outcomes, and Treatment Effectiveness in Patients ≥75 With Atrial Fibrillation.Journal of the American Heart Association · 2020Article
- Efficacy and Safety of Non-Vitamin K Antagonist Oral Anticoagulants in Atrial Fibrillation Patients With Impaired Liver Function: A Retrospective Cohort Study.Journal of the American Heart Association · 2018Article
Corrections and comments
- Commented on by
Authors and funding
19 authors at 10 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPolypharmacy, defined as the concomitant use of multiple medications, is very common in the elderly and may trigger drug-drug interactions and increase the risk of falls in patients receiving vitamin K antagonists.
objectiveTo examine whether polypharmacy increases the risk of bleeding in elderly patients who receive vitamin K antagonists for acute venous thromboembolism (VTE).
designWe used a prospective cohort study.
participantsIn a multicenter Swiss cohort, we studied 830 patients aged ≥ 65 years with VTE. MAIN MEASURES: We defined polypharmacy as the prescription of more than four different drugs. We assessed the association between polypharmacy and the time to a first major and clinically relevant non-major bleeding, accounting for the competing risk of death. We adjusted for known bleeding risk factors (age, gender, pulmonary embolism, active cancer, arterial hypertension, cardiac disease, cerebrovascular disease, chronic liver and renal disease, diabetes mellitus, history of major bleeding, recent surgery, anemia, thrombocytopenia) and periods of vitamin K antagonist treatment as a time-varying covariate. KEY
resultsOverall, 413 (49.8 %) patients had polypharmacy. The mean follow-up duration was 17.8 months. Patients with polypharmacy had a significantly higher incidence of major (9.0 vs. 4.1 events/100 patient-years; incidence rate ratio [IRR] 2.18, 95 % confidence interval [CI] 1.32-3.68) and clinically relevant non-major bleeding (14.8 vs. 8.0 events/100 patient-years; IRR 1.85, 95 % CI 1.27-2.71) than patients without polypharmacy. After adjustment, polypharmacy was significantly associated with major (sub-hazard ratio [SHR] 1.83, 95 % CI 1.03-3.25) and clinically relevant non-major bleeding (SHR 1.60, 95 % CI 1.06-2.42).
conclusionsPolypharmacy is associated with an increased risk of both major and clinically relevant non-major bleeding in elderly patients receiving vitamin K antagonists for VTE.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.