Journal of Thrombosis and Thrombolysis

, Volume 35, Issue 3, pp 312–319 | Cite as

Assessing bleeding risk in patients taking anticoagulants

  • Marwa Shoeb
  • Margaret C. FangEmail author
CME/CNE Article


Anticoagulant medications are commonly used for the prevention and treatment of thromboembolism. Although highly effective, they are also associated with significant bleeding risks. Numerous individual clinical factors have been linked to an increased risk of hemorrhage, including older age, anemia, and renal disease. To help quantify hemorrhage risk for individual patients, a number of clinical risk prediction tools have been developed. These risk prediction tools differ in how they were derived and how they identify and weight individual risk factors. At present, their ability to effective predict anticoagulant-associated hemorrhage remains modest. Use of risk prediction tools to estimate bleeding in clinical practice is most influential when applied to patients at the lower spectrum of thromboembolic risk, when the risk of hemorrhage will more strongly affect clinical decisions about anticoagulation. Using risk tools may also help counsel and inform patients about their potential risk for hemorrhage while on anticoagulants, and can identify patients who might benefit from more careful management of anticoagulation.


Anticoagulation Hemorrhage Risk stratification Warfarin 



Supported by NIH/NCRR UCSF-CTSI Grant Number UL1 RR024131. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Division of Hospital MedicineUniversity of California, San FranciscoSan FranciscoUSA

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