Prevalence of Hemorrhagic Complications in Hospitalized Patients with Pulmonary Embolism

Background: The prevalence of anticoagulant therapy-associated hemorrhagic complications in hospitalized patients with pulmonary embolism (PE) has been scarcely investigated. Aim: To evaluate the prevalence of hemorrhages in hospitalized PE patients. Methods: The Information System ASKLIPIOS (TM) HOSPITAL implemented in the Respiratory Medicine Department, University of Thessaly, was used to collect demographic, clinical and outcome data from January 2013 to April 2021. Results: 326 patients were included. Males outnumbered females. The population's mean age was 68.7 +/- 17.0 years. The majority received low molecular weight heparin (LMWH). Only 5% received direct oral anticoagulants. 15% of the population were complicated with hemorrhage, of whom 18.4% experienced a major event. Major hemorrhages were fewer than minor (29.8% vs. 70.2%, p = 0.001). Nadroparin related to 83.3% of the major events. Hematuria was the most common hemorrhagic event. 22% of patients with major events received a transfusion, and 11% were admitted to intensive care unit (ICU). The events lasted for 3 +/- 2 days. No death was recorded. Conclusions: 1/5 of the patients hospitalized for PE complicated with hemorrhage without a fatal outcome. The hemorrhages were mainly minor and lasted for 3 +/- 2 days. Among LMWHs, nadroparin was related to a higher percentage of hemorrhages.

Automated summary

This study evaluated the prevalence and clinical characteristics of hemorrhages in hospitalized patients with pulmonary embolism. The results showed that approximately one-fifth of the patients experienced hemorrhagic complications, with the majority being minor and of short duration. Nadroparin was the medication most commonly associated with major bleeding events.