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Master Thesis

Une étude rétrospective des dosages d’anticoagulants oraux directs au CHU de Bordeaux : l’étude Rétro- AOD

Abstract : Prescription of direct oral anticoagulant (DOAC : dabigatran, rivaroxaban and apixaban) is increasing. Dosage of the efficacy of these medications is done by specific methods. Literature review is scarce regarding clinical practice of these specific dosages. We retrospectively analyzed 2197 dosages among 1488 patients carried out at the Bordeaux teaching hospital in 2017 and 2018. Almost 80 % of dosages were carried out in patients treated for atrial fibrillation, 15 % for venous thrombo-embolism. In 35 % of cases, dosage was done in the context of an invasive or with an hemorrhagic risk procedure in an emergency setting, 10 % for an ischemic stroke, 16 % for an invasive scheduled procedure, 14 % for a bleeding situation and 13 % in a case of renal failure. 34 % of dosages led to carrying the invasive procedure, 12 % to postpone it and more than 50 % had no impact on the patient’s care. Invasive procedures carried out were in more than 60 % of the cases after a dosage that showed an anticoagulant activity undetectable (< 30 ng/mL). In 95 cases, dosage was done in a context of drug reversion (dosage before reversion to decide of its indication or control after reversion). Correlation with classical hemostasis test was rather poor, as it has already been shown in literature. Our study shows heterogeneous clinical practice regarding DOAC dosages, with a significant number of prescription outside guidelines or that did not led to a significant modification of the patient’s care in a majority of cases.
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https://dumas.ccsd.cnrs.fr/dumas-03261031
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Submitted on : Tuesday, June 15, 2021 - 1:11:02 PM
Last modification on : Thursday, July 8, 2021 - 3:16:00 AM
Long-term archiving on: : Thursday, September 16, 2021 - 6:38:30 PM

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Thibaud Cavaillez. Une étude rétrospective des dosages d’anticoagulants oraux directs au CHU de Bordeaux : l’étude Rétro- AOD. Sciences du Vivant [q-bio]. 2021. ⟨dumas-03261031⟩

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