Most bleeds (93.3%) were managed conservatively with watchful waiting, compression, tamponade, or red blood cell transfusion. None of the minor bleeds and 16% (83/499) of the nonmajor clinically relevant and major bleeds required surgical or interventional treatment, he said.
Fresh frozen plasma and prothrombin complex concentrate were rarely used (seven patients each). No patient received recombinant activated factor VII.
Mortality was 0.4% for all patients with bleeding complications and 6.8% in those with major bleeds.
Death from any cause at 30 days and 90 days post bleeding occurred in 1 of 19 (5.3%) and 3 of 17 (17.6%) patients on dabigatran, respectively; in 5 of 99 (5%) and 6 of 88 (6.8%) on rivaroxaban; and in 1 of 2 (50%) at each time point for the few patients on apixaban.
With vitamin K antagonists, the case-fatality rates of major bleeding reach 14% at 90 days after bleeding leading to hospitalization and 18% within a week of discharge in atrial fibrillation patients, Dr. Beyer-Westendorf observed.