Bleeding complications with oral anticoagulants in the elderly: an observational study

Over recent years, new oral anticoagulant agents (NOAC) have been commercialized as a new treatment in order to prevent or treat thromboembolic events. Although the use of NOACs is easier than for vitamin K antagonists (VKA), their risk-benefit balance still raises concerns, especially in the elderly. To evaluate bleeding complications with anticoagulants agents (NOAC and VKA) among a geriatric population. A retrospective study performed in the four units of the acute geriatric department of CHU Charleroi (116 beds). All the patients who received at least one dose of oral anticoagulant (NOAC or VKA) during their hospitalization between January 1^st 2013 and May 31th 2014 were enrolled. Medical files of 242 patients were analyzed, and the type and severity of bleeding were recorded. Mean age was 84 ± 5.4 years old. Seventy-three percent were prescribed VKA. Rivaroxaban was the most prescribed NOAC among this population. Atrial fibrillation was the primary indication of oral anticoagulation in 73% with VKA and 94% with NOAC. Fourty-six patients presented a bleeding (38 patients (22% of patients with VKA) with VKA and 8 patients with NOAC (12% of patients with NOAC)). We found 13 major bleedings with VKA and only one with NOAC. The results of this study are encouraging concerning the utilization of NOACs in the geriatric population. However, larger studies are needed to confirm this.