The role of individual risk factors in anticoagulant-associated hemorrhages
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Hemorrhagic complications during therapy with anticoagulant drugs have long been considered as simply and directly related to overdosage. Yet, such adverse events have also been observed in patients correctly anticoagulated, i.e., within the therapeutic range, thus demonstrating that the predictive value of laboratory monitoring is, at best, unclear. There are, indeed, individual risk factors leading to bleeding, despite optimal anticoagulant therapy. They may be totally asymptomatic, but screening for such parameters may also be more or less neglected. It is possible to prevent a good number of these complications provided that individual risk factors are carefully sought. Individual risk factors characterize each patient's destiny; to strive to detect them is the physician's responsibility.
Hemorrhagic complications during therapy with anticoagulant drugs have long been considered as simply and directly related to overdosage. Yet, such adverse events have also been observed in patients correctly anticoagulated, i.e., within the therapeutic range, thus demonstrating that the predictive value of laboratory monitoring is, at best, unclear. There are, indeed, individual risk factors leading to bleeding, despite optimal anticoagulant therapy. They may be totally asymptomatic, but screening for such parameters may also be more or less neglected. It is possible to prevent a good number of these complications provided that individual risk factors are carefully sought. Individual risk factors characterize each patient's destiny; to strive to detect them is the physician's responsibility.