Risk factors for bleeding with anticoagulation

Risk factor	Odds ratio for bleeding*
Modifiable risk factors
Active peptic ulcer disease	4
Bleeding episode within the previous 3 months	4
Platelet count <50,000/microL	4
ICU or CCU	2.5
Chronic kidney disease (eGFR <30; 30 to 59; or ≥60 mL/min/m²)	2; 1.5; 1
Liver disease (INR >1.5)	2
Active cancer	2
Rheumatologic disease	2
Central venous catheter	2
Fixed risk factors
Male sex	1.5
Older age (≥85; 40 to 80; or <40 years)	3; 2; 1

These risk factors should be regarded as estimates; it is unclear how the estimated ratios would combine in an individual patient. Refer to UpToDate for details.

ICU: intensive care unit; CCU: coronary care unit; eGFR: estimated glomerular filtration rate; INR: international normalized ratio.
* Numbers are rounded to the nearest 0.5.

Adapted from:

Decousus H, Tapson VF, Bergmann JF, et al. Factors at admission associated with bleeding risk in medical patients: findings from the IMPROVE investigators. Chest 2011; 139:69.
Ortel TL, Neumann I, Ageno W, et al. American Society of Hematology 2020 guidelines for management of venous thromboembolism: treatment of deep vein thrombosis and pulmonary embolism. Blood Adv 2020; 4:4693.

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Risk factors for bleeding with anticoagulation