ĭespite the high efficacy of oral anticoagulation, concerns about their related hemorrhagic complications prevent many patients from being prescribed or maintained on therapy. More recently, novel oral anticoagulants including the direct thrombin inhibitors and factor Xa inhibitors have become available. Vitamin K antagonists (VKAs), primarily warfarin, have been the most frequently used agents for patients requiring chronic 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.Īnticoagulants are commonly used medications in the prevention and treatment of thromboembolic disease. 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. At present, their ability to effective predict anticoagulant-associated hemorrhage remains modest. These risk prediction tools differ in how they were derived and how they identify and weight individual risk factors. To help quantify hemorrhage risk for individual patients, a number of clinical risk prediction tools have been developed. Numerous individual clinical factors have been linked to an increased risk of hemorrhage, including older age, anemia, and renal disease. Although highly effective, they are also associated with significant bleeding risks. Anticoagulant medications are commonly used for the prevention and treatment of thromboembolism.
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