ScholarDeck

Cohort studyJournal of thrombosis and thrombolysis · 2026

Continuation of direct oral anticoagulants versus warfarin during critical illness: bleeding and clinical outcomes in a multicenter ICU cohort.

Amos Lal, Aysun Tekin, Guilherme Leite B Goncalves … John G Park

Internal MedicineCohort study

Hospital mortality was lower with warfarin than with direct oral anticoagulants in intensive care unit patients continuing anticoagulation.

Continuation of direct oral anticoagulants versus warfarin during critical illness: bleeding and clinical outcomes in a multicenter ICU cohort.

Amos Lal … John G Park

Journal of thrombosis and thrombolysis · 2026

Background

A growing proportion of patients admitted to the intensive care unit (intensive care unit) receive chronic oral anticoagulation with direct oral anticoagulants (direct oral anticoagulants) or warfarin.

Methods

We evaluated bleeding and clinical outcomes among intensive care unit patients who continued the same oral anticoagulant during the early intensive care unit course.

n = 2,410 patients

Results

hospital deaths were lower in patients continuing warfarin than direct oral anticoagulants

aOR 1.34 (95% CI 0.89 to 2.02)

CI crosses the null - not significant

More results

The comparative safety of continuing direct oral anticoagulants versus warfarin during critical illness remains uncertain.

The primary outcome was major bleeding during the index hospitalization.

More results

In the multivariable analysis, there was no statistically significant difference in major bleeding events, (aOR 1.34, 95% CI 0.89-2.02; p = 0.161) between the direct oral anticoagulants and warfarin groups, respectively.

“

Conclusion

This discordance suggests that the mortality in this population is driven largely by illness severity, comorbidity, unmeasured confounding and other non-bleeding related pathways.

Post

Continuation of direct oral anticoagulants versus warfarin during critical illness: bleeding and clinical outcomes in a multicenter ICU cohort.

Hospital mortality was lower with warfarin than with direct oral anticoagulants in intensive care unit patients continuing anticoagulation.

Related papers