ArticleEuropean journal of clinical pharmacology2020
Risk factors for severe bleeding events during warfarin treatment: the influence of sex, age, comorbidity and co-medication.
Article in European journal of clinical pharmacology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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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.
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Who cites it
18 citing papers in PubMed, 34 citations in OpenAlex.
- Trial
- Applying machine learning to pharmacovigilance data: A proof-of-concept study.British journal of clinical pharmacology · 2026Article
- Review
- Study of target INR achievement, incidence of hemorrhagic complications and affecting factors after during warfarin treatment in western area of China.Scientific reports · 2025Article
- Review
- Loss of function in protein Z (PROZ) is associated with increased risk of ischemic stroke in the UK Biobank.Journal of thrombosis and haemostasis : JTH · 2025Article
- Risk factors for major bleeding in patients with atrial fibrillation and CKD G3-G5D on oral anticoagulants.Clinical kidney journal · 2024Article
- Bleeding events in thrombotic antiphospholipid syndrome: prevalence, severity, and associated damage accrual.Research and practice in thrombosis and haemostasis · 2024Article
- Selective Serotonin Reuptake Inhibitor (SSRI) Bleeding Risk: Considerations for the Consult-Liaison Psychiatrist.Current psychiatry reports · 2023Review
- Incidence and clinical impact of bleeding events in older patients with acute venous thromboembolism.Blood advances · 2023Article
- An instrument to measure atrial fibrillation knowledge in Chinese patients: validation of the Jessa Atrial fibrillation Knowledge Questionnaire.Frontiers in pharmacology · 2023Article
- Severity and Hospitalization Cost Related to Warfarin-Related Adverse Events in a Tertiary Malaysian Hospital.Hospital pharmacy · 2022Article
- Article
- Warfarin Pharmacogenomics for Precision Medicine in Real-Life Clinical Practice in Southern Africa: Harnessing 73 Variants in 29 Pharmacogenes.Omics : a journal of integrative biology · 2022Article
- Comparison of Immediate and Sequential Withdrawal of a Systemic Glucocorticoid in the Treatment of Acute Exacerbations of Chronic Obstructive Pulmonary Disease: A Multicenter, Randomized, Double-Blind, Parallel-Controlled, Open-Label Study.Frontiers in molecular biosciences · 2021Article
- Correlation Between Serum Concentrations of Menaquinone-4 and Developmental Quotients in Children With Autism Spectrum Disorder.Frontiers in nutrition · 2021Article
- Article
- Evaluation of Patient Characteristics Linked to Major Bleeding Events in Patients Prescribed Direct Oral Anticoagulants.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisArticle
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
Abstract
purposeTo investigate risk factors for severe bleeding during warfarin treatment, including the influence of sex, age, comorbidity and co-medication on bleeding risk.
methodsPatients initiating warfarin treatment between 2007 and 2011 were identified in the nationwide Swedish Prescribed Drug Register, and diagnoses of severe bleeding were retrieved from the National Patient Register. Hazard ratios (HR) with 95% confidence intervals (CI) for severe bleeding were estimated using multiple Cox regression adjusting for indications and including covariates age, sex, comorbidities and co-medications. Interactions between sex and other covariates were investigated.
resultsThe study cohort included 232,624 patients ≥ 18 years (101,011 women and 131,613 men). The incidence rate of severe bleeding was 37 per 1000 person-years, lower among women than men with an adjusted HR (95% CI) of 0.84 (0.80-0.88). Incidence of bleeding increased with age, HR 2.88 (2.37-3.50) comparing age ≥ 80 to < 40 years, and comorbidities associated with the highest risk of severe bleeding were prior bleeding, HR 1.85 (1.74-1.97); renal failure, HR 1.82 (1.66-2.00); and alcohol dependency diagnosis, HR 1.79 (1.57-2.05). Other comorbidities significantly associated with bleeding events were hypertension, diabetes, peripheral vascular disease, congestive heart failure, liver failure, stroke/TIA, COPD and cancer.
conclusionMost of the well-established risk factors were found to be significantly associated with bleeding events in our study. We additionally found that women had a lower incidence of bleeding. Potential biases are selection effects, residual confounding and unmeasured frailty.
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