Severe non-traumatic bleeding events detected by computed tomography: do anticoagulants and antiplatelet agents have a r
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RESEARCH ARTICLE
Open Access
Severe non-traumatic bleeding events detected by computed tomography: do anticoagulants and antiplatelet agents have a role? Olivier Risch1, Agaicha Alfidja1, Aurelien Mulliez2, Anderson H Amani3, Louis Boyer1, Lionel Camilleri3 and Kasra Azarnoush3,4*
Abstract Purpose: Bleeding is the most common and most serious complication of anticoagulant (AC) and antiplatelet agents (APA) which are increasingly used in every day practice. The aim of this study was to enlist and analyze the most severe bleeding events revealed during computed tomography scanner (CT scan) examinations over a 1-year period at our University Hospital and to evaluate the role of ACs and APAs in their occurrence. Methods: This descriptive monocentric retrospective study included all patients who benefited from an emergency CT scan with a diagnosis of severe non-traumatic bleeding. Patients were divided into two groups: those treated with ACs and/or APAs, and those not treated with ACs or APAs. Results: After applying the inclusion criteria, 93 patients were enrolled. Sixty-one patients received an anticoagulant or antiplatelet treatment, and 32 did not receive any AC or APA therapy. Seventy nine percent presented with an intracranial hemorrhage, 17% with a rectus sheath or iliopsoas bleeding or hematoma, and 4% with a quadriceps hematoma. Only patients who received ACs or APAs suffered a muscular hematoma (p 3). Conclusions: In our series, intracranial hemorrhage was preponderant and muscular hematomas occurred exclusively in patients treated with ACs and/or APAs. This study needs to be extended to evaluate the impact of new anticoagulant and antiplatelet agents. Keywords: Intracranial hemorrhage, Muscular hematoma, Anticoagulant, Antiplatelet agents, CT-scan
Background Bleeding is regarded as severe if it has hemodynamic consequences that require transfusion or a hemostatic therapeutic procedure, if vital or functional prognosis is compromised due to its location, or if it cannot be controlled by the usual means. When none of these criteria is present, hemorrhage is qualified as non-severe [1]. Anticoagulants (AC) are the treatment for many pathological conditions, such as venous thromboembolic disease, atrial fibrillation, as well as for patients with * Correspondence: [email protected] 3 Heart surgery Department, G. Montpied Hospital, Clermont-Ferrand University Hospital, Clermont-Ferrand 63000, France 4 INRA, UMR 1019 Nutrition Humaine, Saint Genès Champanelle, France Full list of author information is available at the end of the article
mechanical heart valve prosthesis. Although their efficacy has been widely acknowledged, these drugs can lead to complications, the most frequent and severe of which are hemorrhagic events [1]. Currently, more than 900,000 patients receive vitamin-K antagonists (VKA) in France [2]. VKAs are responsible for most iatrogenic complications [3]. In France, the cost of these complications is more than 300 million Euros per year [3] and anticoagulant-related hemorrhagi
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