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Master Thesis

Événements hémorragiques sous anticoagulants au centre hospitalier intercommunal de Marmande chez les patients de plus de 75 ans

Abstract : Hemorrhagic events under anticoagulants is the main cause of hospitalisation with adverse drug effects leading to a major health issue. Since the direct oral anticoagulants (DOACs) have been approved on the market, the general impression was that there were more bleeding cases under DOACs than under Vitamin K antagonist (VKA) in the elderly people. This led us to a detailled analysis of hemorrhagic events under VKA and DOACs at the Intermunicipal Hospital Center of Marmande. Our primary goal was to determine the frequency and to describe the different hemorrhagic events among patients aged more than seventy-five years old under DOACs or VKA in 2013. The secondary objective was to study the affected population with different complications and to find the contributing factors that increase the risk of bleeding either under DOACs or VKA in the elderly people. Our study included 226 patients, 73% (165/226) of them were under VKA and 27% (61/226) were under DOACs. We found 10,8% (18/165) and 29,5% (18/61) bleeding cases in the VKA and DOAC group respectively. Among the hemorrhagic events, 7,2% (12/165) were considered severe according to HAS criteria 2008 under VKA and 21,3% (13/61) under DOACs. Severe hemorrhagic events observed were blood transfusion, intracranial hemorrhage, major intramuscular hematoma and major gastrointestinal bleeding. Non-severe hemorrhagic events included hematuria and epistaxis : 3,6% (6/165) patients were under VKA and 8,2% (5/61) patients under DOACs. Our study showed that our population had the same clinical and biological caracteristics either in the VKA or in the DOACs group. Unfortunately, we were not able to achieve our secondary goal due to our small population size and the low statistical power of our study. But according to the literature, we must not underestimate the use of anticoagulants. However, we must be more careful in older adults receiving anticoagulants as they are often excluded in studies and no consensus on the choice of anticoagulant has been established until now.
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Master Thesis
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Submitted on : Monday, February 22, 2016 - 5:11:23 PM
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  • HAL Id : dumas-01277551, version 1



Janie Ng'Yuk Shing. Événements hémorragiques sous anticoagulants au centre hospitalier intercommunal de Marmande chez les patients de plus de 75 ans. Médecine humaine et pathologie. 2016. ⟨dumas-01277551⟩



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