Association between prothrombin time and bleeding in hospitalized patients receiving rivaroxaban.
Am J Health Syst Pharm
; 75(22): 1783-1789, 2018 Nov 15.
Article
em En
| MEDLINE
| ID: mdl-30049684
ABSTRACT
PURPOSE:
Results of an investigation of the pharmacodynamic effect of rivaroxaban anticoagulation, as measured by prothrombin time (PT), on bleeding risk and other outcomes in hospitalized patients are reported.METHODS:
In a single-center retrospective cohort study, adult inpatients who had a PT measured within 24 hours after rivaroxaban administration during a designated 23-month period were identified. Patients who experienced in-hospital bleeding events were compared with those who did not. A multivariable logistic regression model was used to quantify the association between PT and bleeding events while adjusting for albumin levels and use of nonsteroidal antiinflammatory drugs and/or antiplatelet agents. Thromboembolic events were assessed as a secondary outcome.RESULTS:
A total of 199 patients met the criteria for inclusion in the analysis; 41 experienced a bleeding event. Among patients with a PT of ≥30 seconds versus a PT of <30 seconds, the overall rate of bleeding events was significantly higher (38.7% versus 17.3%, p = 0.0067). Results of multivariable regression modeling showed that a PT of ≥30 seconds correlated with an approximately 3-fold higher bleeding risk (odds ratio, 3.25; 95% confidence interval, 1.09-9.66). Hypoalbuminemia was also a positive predictor of bleeding risk. There was no significant between-group difference in thromboembolic events.CONCLUSION:
In hospitalized patients receiving rivaroxaban who had coagulation tests performed, a PT of ≥30 seconds was associated with a higher risk of bleeding. Hypoalbuminemia was also associated with bleeding in this population.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Tempo de Protrombina
/
Inibidores do Fator Xa
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Rivaroxabana
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Hemorragia
Tipo de estudo:
Etiology_studies
/
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Am J Health Syst Pharm
Ano de publicação:
2018
Tipo de documento:
Article