0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editor's Correspondence |

Clinical Relevance of Bleeding Index

Gerry Oster, PhD; Montserrat Vera, MD, PhD
Arch Intern Med. 2003;163(22):2794. doi:10.1001/archinte.163.22.2794-a.
Text Size: A A A
Published online

Extract

We read with interest the report of the recent meta-analysis by Turpie and colleagues1 of data from 4 randomized, double-blind clinical trials in which patients undergoing major orthopedic surgery were randomized to receive fondaparinux sodium or enoxaparin sodium to prevent venous thromboembolism (VTE). The authors report that fondaparinux reduced the risk of VTE by approximately 50% but that it also increased the risk of major bleeding by 53%. They point out that the difference in bleeding events was accounted for mainly by an excess risk among fondaparinux-treated patients of major bleeding with a "bleeding index of 2 or more" (number of units of packed red blood cells or whole blood transfused plus prebleeding minus postbleeding hemoglobin [grams per deciliter] values). They suggest that this measure is not "clinically relevant" but provide no data to substantiate this claim.

Topics

hemorrhage

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
Jobs
JAMAevidence.com

The Rational Clinical Examination
What Adverse Events Can Result From a Paracentesis?

brightcove.createExperiences();