ArticleThrombosis research2023
Bleeding related to oral anticoagulants: Trends in US emergency department visits, 2016-2020.
Article in Thrombosis research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 38 citations in OpenAlex.
- System-Wide, Electronic Health Record-Based Medication Alerts for Appropriate Prescribing of Direct Oral Anticoagulants: Pilot Randomized Controlled Trial.JMIR formative research · 2024Trial
- Oral anticoagulants-related bleeding: what happens in the emergency room? The Galeno study.Internal and emergency medicine · 2026Observational
- Leveraging technology to improve care: a real-time electronic dashboard within an anticoagulation stewardship service to optimise anticoagulant safety.Journal of thrombosis and thrombolysis · 2026Article
- The first month after direct oral anticoagulants: a window of vulnerability.Research and practice in thrombosis and haemostasis · 2026Article
- Andexanet Alfa for Life-Threatening Bleeding Following Factor Xa Inhibitor Treatment: Postmarketing Surveillance Study in Japan.JACC. Asia · 2026Article
- Article
- Epigenetic metabolite lipid nanoparticles alleviate venous thrombosis via bone marrow reprogramming.Blood vessels, thrombosis & hemostasis · 2025Article
- Machine Learning for Warfarin Therapy: A Systematic Review.Pharmaceuticals (Basel, Switzerland) · 2025Review
- Emergency Department Visits for Bleeding by Adults Aged ≥ 80 Years Receiving Direct-Acting Oral Anticoagulants.Journal of the American Geriatrics Society · 2025Article
- Major Bleeding in the Emergency Department: A Practical Guide for Optimal Management.Journal of clinical medicine · 2025Review
- In-Hospital Mortality and Hemorrhagic Risks in Traumatic Brain Injury Patients with Early vs. Late Venous Thromboembolism.TH open : companion journal to thrombosis and haemostasis · 2025Article
- Pharmacist Use of a Population Management Dashboard for Safe Anticoagulant Prescribing: Evaluation of a Nationwide Implementation Effort.Journal of the American Heart Association · 2024Article
- Dabigatran accumulation in acute kidney injury: is more better than less to prevent bleeding? A case report.International journal of emergency medicine · 2024Article
- Evaluation and treatment of gastrointestinal bleeding in patients taking anticoagulants presenting to the emergency department.International journal of emergency medicine · 2024Article
- An architecturally rational hemostat for rapid stopping of massive bleeding on anticoagulation therapy.Proceedings of the National Academy of Sciences of the United States of America · 2024Article
- Direct Oral Anticoagulants Versus Vitamin K Antagonist in Elderly Patients With Atrial Fibrillation: Sometimes Less Is More, but Sometimes More Is More.Journal of the American Heart Association · 2023Article
- Research progress on the fibrinolytic enzymes produced from traditional fermented foods.Food science & nutrition · 2023Review
- Oral Anticoagulant Use in Patients with Atrial Fibrillation at Low Risk of Stroke and Associated Bleeding Complications.Journal of clinical medicine · 2023Article
- Exome-wide association study of bleeding events in patients receiving direct oral anticoagulants.Science progressObservational
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
backgroundClinical trials suggest lower rates of major bleeding with direct-acting oral anticoagulants (DOACs) than with warfarin, but anticoagulant-related bleeding remains one of the most common outpatient adverse drug events.
methodsWe estimated the number of emergency department (ED) visits and subsequent hospitalizations for oral anticoagulant-related bleeding in 2016-2020 based on active surveillance in a nationally representative, size-stratified probability sample of 60 U.S. hospitals. We estimated rates of ED visits using a nationally-projected retail prescription dispensing database.
resultsBased on 19,557 cases, oral anticoagulant-related bleeding resulted in an estimated 1,270,259 (95 % Confidence Interval [CI], 644,686-1,895,832) ED visits for the five years 2016-2020, of which 47.8 % (95 % CI, 40.6 %-55.0 %) resulted in hospitalization. Oral anticoagulant-related bleeding resulted in an estimated 230,163 (95% CI, 109,598-350,728) ED visits in 2016 and 301,433 (95% CI, 138,363-464,503) in 2020. During 2016-2020, ED visits for DOAC-related bleeding increased by an average of 27.9 % (95 % CI, 24.0 %-32.0 %; p < .001) per year, while ED visits for warfarin-related bleeding decreased by an average of 8.8 % (95 % CI, -10.7 % to -7.0 %; p = .001) per year. The estimated rate of bleeding visits per 100 patients dispensed oral anticoagulants at least once in 2016-2020 was highest for patients aged ≥ 80 years (13.1; 95 % CI, 6.2-20.0) and lowest for those aged <45 years (4.0; 95 % CI, 2.6-5.5); it was 5.9 visits per 100 patients dispensed DOACs [95 % CI, 2.5-9.2] and 13.0 visits per 100 patients dispensed warfarin [95 % CI, 7.4-18.7].
conclusionsAlthough the rates of ED visits for anticoagulant-related bleeding may be lower for DOACs than for warfarin, persistently large numbers of patients requiring ED visits for anticoagulant-related bleeding despite increased use of DOACs and declining use of warfarin suggest that efforts to improve appropriate prescribing and monitoring of anticoagulants remain important.
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