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The Outpatient Bleeding Risk Index predicted major bleeding in patients taking warfarin

Clinical impact ratings Internal medicine Cardiology Haematology Neurology

Key Words: anticoagulants • haemorrhage

The first 150 words of the full text of this article appear below.

METHODS
Design: retrospective cohort study to validate the previously developed Outpatient Bleeding Risk Index in a veteran population.

Setting: a pharmacist run anticoagulation clinic at the Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.

Patients: 1269 patients (mean age 68 y, 92% men, 82% white) taking warfarin for <1 to >36 months.

Description of prediction guide: the Outpatient Bleeding Risk Index (range 0–4) is a summation of 4 factors: (i) age (65 y = 1), (ii) history of stroke = 1, (iii) history of gastrointestinal bleeding = 1, and (iv) presence of 1 serious comorbidity (recent myocardial infarction, haematocrit <30%, serum creatinine concentration >1.5 mg/dl, or diabetes mellitus = 1). The index categorised patients into 3 risk groups: high risk (score of 3–4), intermediate risk (score of 1–2), and low risk (score of 0). Bleeding episodes were identified through quality assurance reports. Poisson regression analysis was used to determine the . . . [Full text of this article]

John W Eikelboom, MD

McMaster University
Hamilton, Ontario, Canada