Table 3.
Univariate and multivariate analyses for risk factors for major bleeding events and for major upper gastrointestinal bleeding
|
Major bleed |
Major upper gastrointestinal bleed |
|||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Univariate analysis |
Adjusted for age and sex |
Multivariate analysis* |
Univariate analysis |
Adjusted for age and sex |
Multivariate analysis* |
|||||||
| HR (95% CI) | p value | HR (95% CI) | p value | HR (95% CI) | p value | HR (95% CI) | p value | HR (95% CI) | p value | HR (95% CI) | p value | |
| Age (per 10 years) | 1·68 (1·47–1·93) | <0·0001 | 1·72 (1·50–1·97) | <0·0001 | 1·72 (1·47–2·02) | <0·0001 | 1·82 (1·50–2·22) | <0·0001 | 1·86 (1·53–2·26) | <0·0001 | 1·97 (1·59–2·45) | <0·0001 |
| Female | 1·14 (0·86–1·52) | 0·37 | 0·84 (0·62–1·13) | 0·24 | 0·90 (0·67–1·22) | 0·50 | 1·18 (0·79–1·76) | 0·42 | 0·83 (0·55–1·25) | 0·38 | 0·91 (0·60–1·37) | 0·64 |
| Weight (per kg) | 0·98 (0·97–0·99) | 0·0006 | 0·99 (0·98–1·00) | 0·17 | .. | .. | 0·98 (0·97–1·00) | 0·0164 | 1·00 (0·98–1·01) | 0·53 | .. | .. |
| History of vascular disease† | 1·69 (1·25–2·27) | 0·0006 | 1·33 (0·98–1·80) | 0·06 | 1·16 (0·85–1·57) | 0·36 | 1·93 (1·29–2·90) | 0·0015 | 1·50 (0·99–2·25) | 0·05 | 1·23 (0·81–1·87) | 0·33 |
| Hypertension | 1·52 (1·13–2·05) | 0·0056 | 1·28 (0·95–1·73) | 0·10 | .. | .. | 1·50 (1·00–2·27) | 0·05 | 1·25 (0·83–1·89) | 0·29 | .. | .. |
| Diabetes | 1·60 (1·11–2·29) | 0·0108 | 1·68 (1·17–2·41) | 0·0047 | 1·46 (1·01–2·13) | 0·05 | 1·67 (1·02–2·74) | 0·0401 | 1·79 (1·09–2·93) | 0·0210 | 1·46 (0·87–2·45) | 0·15 |
| Hyperlipidaemia | 1·11 (0·82–1·50) | 0·52 | 1·14 (0·84–1·54) | 0·41 | .. | .. | 1·12 (0·74–1·72) | 0·59 | 1·17 (0·77–1·79) | 0·47 | .. | .. |
| Current smoking‡ | 0·86 (0·59–1·25) | 0·42 | 1·54 (1·03–2·30) | 0·0370 | 1·61 (1·07–2·42) | 0·0224 | 1·15 (0·71–1·86) | 0·58 | 2·32 (1·38–3·89) | 0·0014 | 2·39 (1·41–4·02) | 0·001 |
| Alcohol >14 units per week§ | 0·88 (0·58–1·33) | 0·55 | 1·22 (0·79–1·88) | 0·37 | .. | .. | 1·02 (0·59–1·77) | 0·95 | 1·51 (0·85–2·70) | 0·16 | .. | .. |
| Anaemia¶ | 1·74 (1·26–2·39) | 0·0007 | 1·53 (1·11–2·11) | 0·0095 | 1·31 (0·94–1·83) | 0·11 | 2·25 (1·48–3·43) | 0·0002 | 1·96 (1·29–3·00) | 0·0018 | 1·58 (1·02–2·45) | 0·0429 |
| History of cancer | 2·22 (1·55–3·18) | <0·0001 | 1·75 (1·22–2·52) | 0·0026 | 1·86 (1·29–2·69) | 0·0009 | 2·48 (1·52–4·02) | 0·0002 | 1·91 (1·17–3·11) | 0·0098 | 2·06 (1·25–3·38) | 0·0043 |
| Chronic liver disease | 2·23 (0·92–5·43) | 0·08 | 2·81 (1·15–6·84) | 0·0232 | 2·35 (0·95–5·77) | 0·06 | 3·47 (1·27–9·43) | 0·0150 | 4·53 (1·66–12·37) | 0·0032 | 3·77 (1·37–10·42) | 0·0104 |
| Renal failure‖ | 5·80 (2·96–11·36) | <0·0001 | 5·54 (2·83–10·85) | <0·0001 | 4·69 (2·32–9·48) | <0·0001 | 8·87 (4·10–19·21) | <0·0001 | 8·49 (3·92–18·38) | <0·0001 | 7·20 (3·17–16·39) | <0·0001 |
| Atrial fibrillation | 2·09 (1·41–3·09) | 0·0002 | 1·38 (0·93–2·07) | 0·11 | .. | .. | 1·82 (1·03–3·21) | 0·0393 | 1·14 (0·64–2·04) | 0·66 | .. | .. |
| Chronic heart failure | 2·08 (1·37–3·15) | 0·0006 | 1·44 (0·94–2·19) | 0·09 | 1·23 (0·80–1·89) | 0·35 | 1·79 (0·98–3·28) | 0·06 | 1·18 (0·64–2·19) | 0·59 | .. | .. |
| History of peptic ulcer | 1·99 (1·32–2·99) | 0·0010 | 1·67 (1·11–2·52) | 0·0140 | 1·61 (1·07–2·44) | 0·0244 | 2·32 (1·36–3·96) | 0·0021 | 1·93 (1·13–3·32) | 0·0167 | 1·79 (1·04–3·10) | 0·0369 |
| Premorbid antiplatelet | 1·47 (1·10–1·96) | 0·0090 | 1·09 (0·81–1·46) | 0·57 | .. | .. | 1·49 (1·00–2·22) | 0·05 | 1·07 (0·72–1·61) | 0·73 | .. | .. |
| Dual antiplatelet post-event** | 0·82 (0·61–1·10) | 0·18 | 0·96 (0·71–1·30) | 0·81 | .. | .. | 0·77 (0·51–1·17) | 0·22 | 0·93 (0·61–1·43) | 0·75 | .. | .. |
| Premorbid PPI/H2-antagonist | 1·35 (0·99–1·86) | 0·06 | 1·15 (0·84–1·59) | 0·38 | .. | .. | 1·16 (0·73–1·82) | 0·53 | 0·97 (0·62–1·53) | 0·90 | .. | .. |
Major bleeds were bleeds that were substantially disabling with persistent sequelae, intraocular bleeding leading to significant loss of vision, or bleeding requiring transfusion of 2 or more units of blood. HR=hazard ratio. PPI=proton-pump inhibitor. H2-antagonist=histamine2–receptor antagonist.
Risk factors that approached significance (p<0·10) in the age-adjusted and sex-adjusted regression were entered into multivariable Cox regression analysis.
History of stroke, transient ischaemic attack, myocardial infarction, or peripheral vascular disease.
Data missing for 21 patients.
Data missing for 202 patients.
Baseline haemoglobin less than 13 g/L in men and 12 g/L in women.
Glomerular filtration rate of less than 30 mL/min, estimated with the Cockroft and Gault formula.
Mainly aspirin and clopidogrel, and was routinely prescribed for a short period after the index event.