{"id":11487,"date":"2020-05-17T04:48:54","date_gmt":"2020-05-17T02:48:54","guid":{"rendered":"http:\/\/news-papers.eu\/?p=11487"},"modified":"2020-05-11T20:58:23","modified_gmt":"2020-05-11T18:58:23","slug":"schwere-blutungen-unter-oralen-antikoagulanzien","status":"publish","type":"post","link":"https:\/\/news-papers.eu\/?p=11487","title":{"rendered":"Schwere Blutungen unter oralen Antikoagulanzien"},"content":{"rendered":"

\"\"Lindhoff-Last, et al.<\/span>Schwere Blutungen unter oralen Antikoagulanzien.\u00a0Eine prospektive Beobachtungsstudie zum klinischen Verlauf unter Vitamin-K-Antagonisten (VKA) oder direkten oralen Antikoagulanzien (DOAK). Dtsch Arztebl Int 2020; 117: 312-9<\/span>; DOI: 10.3238\/arztebl.2020.0312 (PDF<\/strong><\/a>)<\/h4>\n
    \n
  • prospektive, multizentrische Beobachtungsstudie<\/li>\n
  • prim\u00e4re Endpunkt: Mortalit\u00e4t im Krankenhaus bis einschlie\u00dflich Tag 30 nach station\u00e4rer Aufnahme<\/li>\n
  • Sekund\u00e4re Endpunkte: Blutungsdauer,<\/li>\n
  • 193 Patienten mit starken Blutungen, davon \u00a097 mit VKA und 96 mit DOAK<\/li>\n
  • 13,0\u00a0% (95-%-Konfidenzintervall<\/span>: [8,6; 18,5]; 25\/193) der Patienten verstarben bis Tag 30 nach station\u00e4rer Aufnahme\n
      \n
    • 17,5\u00a0% ([10,6; 26,6]; 17\/97) in der VKA-Gruppe<\/li>\n
    • 8,3\u00a0% ([3,7; 15,8]; 8\/96) in der DOAK-Gruppe (p =\u00a00,085)<\/li>\n
    • Die mediane Blutungsdauer\n
        \n
      • VKA-Gruppe 19,8 Stunden<\/li>\n
      • DOAK-Gruppe 27,8 Stunden (p =\u00a00,632<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n
      • blutungsbedingte Mortalit\u00e4t im Krankenhaus \u00a0in der VKA-Gruppe h\u00f6her als in der DOAK-Gruppe (15,5\u00a0% [15\/97] gegen\u00fcber 4,2\u00a0% [4\/97]; p =\u00a00,014)<\/li>\n
      • Verwendung von Prothrombinkomplexkonzentraten (PPSB) reduzierte die mediane Blutungsdauer bei beiden Patientengruppen<\/li>\n
      • 35\u00a0% (68\/193) der Patienten wurde Blutung durch \u00e4u\u00dfere Trigger verursacht (haupts\u00e4chlich St\u00fcrze)<\/li>\n<\/ul>\n

        Merke:\u00a0<\/u>Die Krankenhausmortalit\u00e4t lag bei mit VKA-behandelten Patienten nominell h\u00f6her als bei mit DOAK behandelten Patienten, obwohl keine statistische Signifikanz<\/span> erreicht wurde.<\/p>\n","protected":false},"excerpt":{"rendered":"

        Lindhoff-Last, et al.Schwere Blutungen unter oralen Antikoagulanzien.\u00a0Eine prospektive Beobachtungsstudie zum klinischen Verlauf unter Vitamin-K-Antagonisten (VKA) oder direkten oralen Antikoagulanzien (DOAK). Dtsch Arztebl Int 2020; 117: 312-9; DOI: 10.3238\/arztebl.2020.0312 (PDF) prospektive, […]<\/p>\n","protected":false},"author":2,"featured_media":10443,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"__cvm_playback_settings":[],"__cvm_video_id":"","jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[1210],"tags":[186],"class_list":["post-11487","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blutungsmanagement","tag-blutung"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/10\/Bildschirmfoto-2019-10-25-um-21.37.13.png?fit=1362%2C910&ssl=1","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p7fR2g-2Zh","jetpack-related-posts":[{"id":7986,"url":"https:\/\/news-papers.eu\/?p=7986","url_meta":{"origin":11487,"position":0},"title":"Neurologisch komplex: Sinusvenenthrombose","author":"Michael Bernhard","date":"September 12, 2018","format":false,"excerpt":"Eine aktuelle Leitlinie zur Diagnostik und Therapie zum Thema Zerebrale Venen-\u00a0und Sinusthrombose : Weimar C. Kurth T., et al., Zerebrale Venen- und Sinusthrombose, S2k-Leitlinie, 2018; in: Deutsche Gesellschaft f\u00fcr Neurologie (Hrsg.), Leitlinien f\u00fcr Diagnostik und Therapie in der Neurologie.\u00a0(PDF) Die neusten Empfehlungen: Patienten mit akuter zerebraler Sinus-\/Venenthrombose (CVST) k\u00f6nnen vorzugsweise\u2026","rel":"","context":"In "Neurologischer Notfall"","block_context":{"text":"Neurologischer Notfall","link":"https:\/\/news-papers.eu\/?cat=7"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2018\/08\/Bildschirmfoto-2018-08-18-um-09.50.18.png?fit=1200%2C665&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2018\/08\/Bildschirmfoto-2018-08-18-um-09.50.18.png?fit=1200%2C665&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2018\/08\/Bildschirmfoto-2018-08-18-um-09.50.18.png?fit=1200%2C665&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2018\/08\/Bildschirmfoto-2018-08-18-um-09.50.18.png?fit=1200%2C665&ssl=1&resize=700%2C400 2x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2018\/08\/Bildschirmfoto-2018-08-18-um-09.50.18.png?fit=1200%2C665&ssl=1&resize=1050%2C600 3x"},"classes":[]},{"id":17081,"url":"https:\/\/news-papers.eu\/?p=17081","url_meta":{"origin":11487,"position":1},"title":"Das haben wir schon immer so gemacht! Pr\u00e4klinischer Einsatz von Antikoagulanzien und Thrombozytenaggregationshemmern bei Patienten mit akutem Thoraxschmerz","author":"Michael Bernhard","date":"Mai 13, 2023","format":false,"excerpt":"Das haben wir schon immer so gemacht! Pr\u00e4klinischer Einsatz von Antikoagulanzien und Thrombozytenaggregationshemmern bei Patienten mit akutem Thoraxschmerz Ein Beitrag von Dr. Robert Stangl, K\u00f6ln: Der akute Thoraxschmerz ist ein h\u00e4ufiger Alarmierungsgrund des Rettungsdienstes. Die Genese ist mannigfaltig und das Spektrum potenziell lebensbedrohlicher Differenzialdiagnosen ist gro\u00df. Im Gegensatz zu einem\u2026","rel":"","context":"In "Kardiovaskul\u00e4rer Notfall"","block_context":{"text":"Kardiovaskul\u00e4rer Notfall","link":"https:\/\/news-papers.eu\/?cat=1079"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/11\/Herz.jpg?fit=1200%2C600&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/11\/Herz.jpg?fit=1200%2C600&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/11\/Herz.jpg?fit=1200%2C600&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/11\/Herz.jpg?fit=1200%2C600&ssl=1&resize=700%2C400 2x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/11\/Herz.jpg?fit=1200%2C600&ssl=1&resize=1050%2C600 3x"},"classes":[]},{"id":12367,"url":"https:\/\/news-papers.eu\/?p=12367","url_meta":{"origin":11487,"position":2},"title":"Sch\u00e4del-Hirn-Trauma und direkte orale Antikoagulantien","author":"Michael Bernhard","date":"November 4, 2020","format":false,"excerpt":"Notaufnahmen sind mit einer zunehmenden Anzahl an Patienten mit traumatischen Sch\u00e4del-Hirntrauma konfrontiert, die direkte orale Antikoagulanzien (DOACs) einnehmen. Es besteht Unsicherheit \u00fcber das Blutungsrisiko, die Rate der H\u00e4matomausdehnung und die Wirksamkeit einer Antagonisierung bei diesen Patienten. Santing AL, et al. TRAUMATIC BRAIN INJURY IN PATIENTS RECEIVING DIRECT ORAL ANTICOAGULANTS. J\u2026","rel":"","context":"In "SHT"","block_context":{"text":"SHT","link":"https:\/\/news-papers.eu\/?cat=1293"},"img":{"alt_text":"SHT","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2020\/10\/egg-583163_1920.jpg?fit=1200%2C998&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2020\/10\/egg-583163_1920.jpg?fit=1200%2C998&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2020\/10\/egg-583163_1920.jpg?fit=1200%2C998&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2020\/10\/egg-583163_1920.jpg?fit=1200%2C998&ssl=1&resize=700%2C400 2x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2020\/10\/egg-583163_1920.jpg?fit=1200%2C998&ssl=1&resize=1050%2C600 3x"},"classes":[]},{"id":13550,"url":"https:\/\/news-papers.eu\/?p=13550","url_meta":{"origin":11487,"position":3},"title":"Sturz unter oraler Antikoagulation: DOACs oder Marcumar schlimmer?","author":"Michael Bernhard","date":"Mai 16, 2021","format":false,"excerpt":"St\u00fcrze aus dem Stand sind bei \u00e4lteren Menschen h\u00e4ufig und mit einem signifikanten Blutungsrisiko verbunden. M\u00fcller M, et al. Falls in ED patients: do elderly patients on direct oral anticoagulants bleed less than those on vitamin K antagonists? Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine (2021) 29:56 (PDF) In\u2026","rel":"","context":"In "Trauma"","block_context":{"text":"Trauma","link":"https:\/\/news-papers.eu\/?cat=6"},"img":{"alt_text":"Sturz","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/04\/metaphor-1209691_1920-e1617726954910.jpg?fit=1000%2C675&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/04\/metaphor-1209691_1920-e1617726954910.jpg?fit=1000%2C675&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/04\/metaphor-1209691_1920-e1617726954910.jpg?fit=1000%2C675&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/04\/metaphor-1209691_1920-e1617726954910.jpg?fit=1000%2C675&ssl=1&resize=700%2C400 2x"},"classes":[]},{"id":6550,"url":"https:\/\/news-papers.eu\/?p=6550","url_meta":{"origin":11487,"position":4},"title":"ASS beim Akuten Koronarsyndrom: Ja, und wie?","author":"Michael Bernhard","date":"Februar 12, 2018","format":false,"excerpt":"Ein Beitrag von PD Dr. J\u00fcrgen Knapp, Bern\/Schweiz: Die ESC-Leitlinien zum akuten Koronarsyndrom (ACS) empfehlen die Gabe von 150-300 mg Acetylsalicyls\u00e4ure (ASS) oral oder 75-250 mg i.v. zur Thrombozytenaggregationshemmung so fr\u00fch wie m\u00f6glich (Klasse I, Empfehlungsgrad B). In der ACUTE-Studie wurde der Beginn des thrombozytenhemmenden Effekts nach Gabe von 250\u2026","rel":"","context":"In "Pharmakologie"","block_context":{"text":"Pharmakologie","link":"https:\/\/news-papers.eu\/?cat=188"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/04\/EKG_Herz.jpg?fit=1200%2C675&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/04\/EKG_Herz.jpg?fit=1200%2C675&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/04\/EKG_Herz.jpg?fit=1200%2C675&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/04\/EKG_Herz.jpg?fit=1200%2C675&ssl=1&resize=700%2C400 2x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/04\/EKG_Herz.jpg?fit=1200%2C675&ssl=1&resize=1050%2C600 3x"},"classes":[]},{"id":17029,"url":"https:\/\/news-papers.eu\/?p=17029","url_meta":{"origin":11487,"position":5},"title":"H\u00e4mostyptika in antikoaguliertem Blut getestet","author":"Bj\u00f6rn Hossfeld","date":"Mai 3, 2023","format":false,"excerpt":"Dass H\u00e4mostyptika zur Blutstillung im milit\u00e4rischen Umfeld beitragen, ist hinreichend publiziert. Allerdings sind blutende Patienten im milit\u00e4rischen Einsatz in der Regel jung, gesund und nicht antikoaguliert. Das stellt sich im zivilen Rettungsdienst v\u00f6llig anders dar: viele gerade \u00e4ltere Patienten haben eine gerinnungshemmende Dauermedikation. Raimund Lechner, Anna Schmid und Katharina Hanke\u2026","rel":"","context":"In "Blutstillung"","block_context":{"text":"Blutstillung","link":"https:\/\/news-papers.eu\/?cat=4"},"img":{"alt_text":"ROTEM","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/09\/Bildschirmfoto-2016-09-03-um-09.52.10-e1682837439132.png?fit=854%2C901&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/09\/Bildschirmfoto-2016-09-03-um-09.52.10-e1682837439132.png?fit=854%2C901&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/09\/Bildschirmfoto-2016-09-03-um-09.52.10-e1682837439132.png?fit=854%2C901&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/09\/Bildschirmfoto-2016-09-03-um-09.52.10-e1682837439132.png?fit=854%2C901&ssl=1&resize=700%2C400 2x"},"classes":[]}],"jetpack_likes_enabled":true,"_links":{"self":[{"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/11487","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=11487"}],"version-history":[{"count":1,"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/11487\/revisions"}],"predecessor-version":[{"id":11488,"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/11487\/revisions\/11488"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/media\/10443"}],"wp:attachment":[{"href":"https:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=11487"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=11487"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=11487"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}