Scientific Poster Session III - Original Research

Abstract

Research Question or Hypothesis:

Does hypoalbuminemia increase bleeding risk in apixaban-treated patients?

Study Design:

Methods:

Adult inpatients admitted from May-July 2023 were reviewed. Inclusion criteria were: apixaban =2.5 mg twice daily given inpatient for =48 hours or prescribed upon discharge and in patients with an albumin level drawn during index admission. Patients with a stroke or TIA within 14 days, bleeding with another anticoagulant, pregnancy, active COVID-19, cirrhosis, or thrombocytopenia were excluded. The primary endpoint assessed the impact of hypoalbuminemia (albumin =3g/dL) on International Society on Thrombosis and Hemostasis criteria bleeding rates in apixaban-treated patients. Bleeding risk was assessed using multivariable logistic regression with backwards stepwise elimination of variables with a p-value <0.2 on bivariate analysis. Alpha was set at <0.05 and SAS version 9.4 was used for analysis.

Results:

A total of 391 patients were included. Bleeding occurred in 49 (12.5%) patients. Albumin =3 g/dL was associated with a 2-fold increase in adjusted bleed risk (OR 2.002, 95% CI [1.003-3.996], p=0.0491). After backward stepwise elimination, gastroduodenal ulcer history (OR 1.428, 95% CI [1.003-2.032], p=0.0480) and proton pump inhibitor use (OR 2.278 [1.225-4.238], p=0.0093) were also associated with bleeding risk in the multivariable model.

Conclusion: