Emergency Visits for Oral Anticoagulant Bleeding
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Bleeding Related to Oral Anticoagulants: US Emergency Department Visits, 2017
Warfarin was the mainstay of outpatient antithrombotic management for decades, but in 2010, direct-acting oral anticoagulants (DOACs) were introduced with fixed dosing and without requirements for laboratory monitoring.1 Clinical trials suggested lower rates of major bleeding with DOACs than with warfarin.2, 3 The number of patients prescribed DOACs has been increasing, yet the number treated for emergent DOAC-related bleeding in the USA is unknown.4
We estimated emergency department (ED) visits for oral anticoagulant-related bleeding using the National Electronic Injury Surveillance System–Cooperative Adverse Drug Event Surveillance (NEISS-CADES) project, an active public health surveillance system based on a nationally representative, size-stratified probability sample of US hospitals. As described previously, trained abstractors record clinician-diagnosed adverse drug events (ADEs)...
The authors thank Ms. Arati Baral and Mr. Alex Tocitu, from Northrop Grumman (contractor to CDC), for assistance with data coding and programming. The authors also thank Mr. Tom Schroeder, Ms. Elenore Sonski, and Mr. Herman Burney, and data abstractors from the US Consumer Product Safety Commission, for their assistance with data acquisition; as well as Dr. Ruth Moro, MD, MPH, for editing assistance. No individuals named herein received compensation for their contributions.
Dr. Geller had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Study concept and design: Geller, Shehab, Budnitz
Acquisition of data: all authors
Analysis and interpretation of data: all authors
Drafting of the manuscript: Geller, Shehab, Budnitz
Critical revision of the manuscript for important intellectual content: all authors
Statistical analysis: Geller
Administrative, technical, and material support: all authors
Study supervision: Geller, Shehab, Budnitz
The funding source was the US federal government.
Compliance with Ethical Standards
Federal government employees led or participated in all aspects of the project, including design and conduct of the project; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The findings and conclusions in this study are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Conflict of Interest
The authors declare that they do not have a conflict of interest.