Table 1. Patients who may benefit from direct oral anticoagulant (DOAC) blood level testing.
| Higher risk of bleeding | Higher risk of elevated DOAC blood level | Risk of severe complications from bleeding |
|---|---|---|
| Advanced age (>75 y) | Renal failure (eGFR less than 30 mL/min) | Procedure at risk of permanent organ/tissue damage from bleeding (e.g., neurosurgery) |
| Procedure at high risk of bleeding (>2% major bleeding) | Liver failure (Child–Pugh B and C) | Spinal/epidural anesthesia |
| History of previous bleeding after surgery | Low body weight (<50 kg) | |
| History of unexplained bleeding suggesting a bleeding diathesis | Polytherapy and concomitant interferent drugs (e.g., amiodarone) | |
| Concomitant antiplatelet agents or other antithrombotic drugs | ||
| Platelet count < 70,000/mm 3 | ||
| Prolonged prothrombin time (PT) and/or activated partial thromboplastin time (aPTT) and/or thrombin time (TT), hypofibrinogenemia | ||
| Known bleeding disorders |
Abbreviation: eGFR, estimated glomerular filtration rate.