Predictive value of the present-on-admission indicator for hospital-associated hemorrhage

• Authors: Roxanne Ghazvinian, Emory University; Richard H White, University of California, Davis; Brian F Gage, Washington University in St. Louis; Margaret C Fang, University of California, San Francisco; Rabia Saeed, University of California, Davis; Raman R Khanna, University of California, San Francisco
• Journal Title: Thrombosis Research
• Volume: Volume 180
• Publisher: Elsevier Ltd | 2019-08-01, Pages 20-24
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1016/j.thromres.2019.05.014
• Subjects: Health Sciences, Medicine and Surgery
• Keywords: Aged; Female; Hemorrhage; Hospitalization; Humans; Male; Middle Aged; Predictive Value of Tests; Retrospective Studies

Abstract

Major hemorrhage is a common presenting diagnosis for admission to the hospital, but it can also occur during hospitalization without provocation or as a complication of anticoagulant use. Full-dose anticoagulant use is known to be the most important risk factor for in-hospital gastrointestinal bleed (GIB).1 The ability to distinguish between hemorrhage that develops prior to hospitalization vs. hemorrhage associated with hospitalization is important for accurate quality assessment.2 Additionally, some hospital-associated conditions, such as pressure ulcer or catheter-associated urinary tract infection, cannot be used for billing; if hospital-associated hemorrhage is added to this list, distinguishing hospital-associated hemorrhage from hemorrhage prior-to-admission will become financially relevant.