Table 3.

Physician Reasons for Non-prescription of OAC Therapy on Discharge^a

Reason	All patients discharged off OAC N=502 n (%)
Fall risk	134 (26.7)
Poor prognosis/comfort care only	97 (19.3)
Prior bleed	86 (17.1)
Patient/family refusal	75 (14.9)
Increased age	55 (11.0)
Poor mental status/dementia	47 (9.4)
Risk of hemorrhagic conversion of IS	44 (8.8)
No AF captured during hospitalization, paroxysmal AF, or prior cardioversion of AF	35 (7.0)
Hemorrhagic conversion of IS	34 (6.8)
Current bleed	30 (6.0)
Increased risk of bleeding	17 (3.4)
Source of stroke thought to be non cardio-embolic and unrelated to AF	16 (3.2)
Warfarin status to be determined as an outpatient	16 (3.2)
Allergy or intolerance to warfarin	9 (1.8)
History of medication non-adherence	9 (1.8)
Elevated INR/difficulty controlling INR	6 (1.2)
Planned procedure/surgery/dentistry	2 (0.4)
Underlying coagulopathy	2 (0.4)
Otherb	13 (2.6)

^aPatients could have more than one reason cited for non-prescription of OAC therapy at discharge. 345 (69%) patients had reasons for non-use of OAC specifically stated in the medical chart. For 157 (31%), reasons were clinically apparent but not specifically stated in the medical chart.

^bIn ATRIA, specific reasons listed under ‘other’ included: ‘improving exam’, ‘visual disturbance’, ‘no evident benefit to anticoagulation’, ‘not a good candidate’, ‘not an anticoagulation candidate’ and ‘rare episodes of paroxysmal AF’. In ATRIA-CVRN, reasons listed under ‘other’ included: ‘outpatient physicians had previously decided not to anticoagulate’ and ‘aspirin alone recommended by neurology consult for unknown reasons’.