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Contribution of bleeding and thromboembolic events to in-hospital mortality among patients with thrombocytopenia treated with heparin.

Publication ,  Journal Article
Jolicoeur, EM; Ohman, EM; Honeycutt, E; Becker, RC; Crespo, EM; Oliveira, GBF; Moliterno, DJ; Anstrom, KJ; Granger, CB
Published in: Am J Cardiol
July 15, 2009

In a population of patients experiencing thrombocytopenia while treated with heparin, bleeding and thromboses are well-appreciated complications, but their relative contributions to mortality have been less well described. In this population, the aims of this study were (1) to identify the independent predictors of bleeding and (2) to compare the incidence and the strength of association of bleeding and of new thromboses to in-hospital mortality. The independent predictors of bleeding and in-hospital mortality were identified using multivariate logistic regression models on the 1,478 patients who developed thrombocytopenia after their enrollment in the Complications After Thrombocytopenia Caused by Heparin (CATCH) study. The independent predictors of bleeding were chronic hematologic disorders, intra-aortic balloon pump, congestive heart failure, and platelet count nadir <120 x 10(9)/L. Although bleeding (n = 141 [10%]) and thromboembolic complications (n = 135 [9%]) were equally prevalent, the former was less strongly associated than the latter with in-hospital mortality (odds ratio 1.75, 95% confidence interval 1.01 to 3.03, and odds ratio 2.77, 95% confidence interval 1.67 to 4.61, respectively). In conclusion, medical management should be directed mainly at the prevention of thromboembolic complications, while additionally considering the risk for bleeding.

Duke Scholars

Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

July 15, 2009

Volume

104

Issue

2

Start / End Page

292 / 297

Location

United States

Related Subject Headings

  • Thromboembolism
  • Thrombocytopenia
  • Risk Factors
  • Registries
  • Odds Ratio
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Incidence
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Jolicoeur, E. M., Ohman, E. M., Honeycutt, E., Becker, R. C., Crespo, E. M., Oliveira, G. B. F., … Granger, C. B. (2009). Contribution of bleeding and thromboembolic events to in-hospital mortality among patients with thrombocytopenia treated with heparin. Am J Cardiol, 104(2), 292–297. https://doi.org/10.1016/j.amjcard.2009.03.034
Jolicoeur, E Marc, E Magnus Ohman, Emily Honeycutt, Richard C. Becker, Eric M. Crespo, Gustavo B. F. Oliveira, David J. Moliterno, Kevin J. Anstrom, and Christopher B. Granger. “Contribution of bleeding and thromboembolic events to in-hospital mortality among patients with thrombocytopenia treated with heparin.Am J Cardiol 104, no. 2 (July 15, 2009): 292–97. https://doi.org/10.1016/j.amjcard.2009.03.034.
Jolicoeur EM, Ohman EM, Honeycutt E, Becker RC, Crespo EM, Oliveira GBF, et al. Contribution of bleeding and thromboembolic events to in-hospital mortality among patients with thrombocytopenia treated with heparin. Am J Cardiol. 2009 Jul 15;104(2):292–7.
Jolicoeur, E. Marc, et al. “Contribution of bleeding and thromboembolic events to in-hospital mortality among patients with thrombocytopenia treated with heparin.Am J Cardiol, vol. 104, no. 2, July 2009, pp. 292–97. Pubmed, doi:10.1016/j.amjcard.2009.03.034.
Jolicoeur EM, Ohman EM, Honeycutt E, Becker RC, Crespo EM, Oliveira GBF, Moliterno DJ, Anstrom KJ, Granger CB. Contribution of bleeding and thromboembolic events to in-hospital mortality among patients with thrombocytopenia treated with heparin. Am J Cardiol. 2009 Jul 15;104(2):292–297.
Journal cover image

Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

July 15, 2009

Volume

104

Issue

2

Start / End Page

292 / 297

Location

United States

Related Subject Headings

  • Thromboembolism
  • Thrombocytopenia
  • Risk Factors
  • Registries
  • Odds Ratio
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Incidence
  • Humans