{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T19:56:18Z","timestamp":1790279778415,"version":"4.1.0"},"reference-count":50,"publisher":"American Society of Hematology","issue":"1","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,11,30]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The majority of patients with venous thromboembolism (VTE) have a considerable long-term risk of recurrence and may require extended duration of anticoagulant treatment after the initial 3 to 6 months. The decision to extend treatment is based not only on the individual risk of recurrence, but should also consider the potential complications associated with anticoagulation, taking into account that anticoagulant drugs are among the drugs most frequently associated with hospital admission due to adverse drug reactions. The most feared complication of oral anticoagulants is bleeding, which in some cases may be fatal or may affect critical organs. Case-fatality rates of bleeding have been reported to be \u223c3 times higher than case-fatality rates of recurrent VTE. Even when nonserious, bleeding may require medical intervention and\/or may impact on patient quality of life or working activity. Factors associated with bleeding during anticoagulant treatment include, among others, advanced age, cancer, renal or liver insufficiency, or concomitant antithrombotic drugs, but no bleeding risk score is sufficiently accurate for use in clinical practice. Not uncommonly, bleeding occurs as a complication of trauma or medically invasive procedures. Nonbleeding complications associated with oral anticoagulants are unusual, and their relevance is extremely uncertain, and include vascular calcification, anticoagulation-related nephropathy, and osteoporosis. Finally, because VTE not uncommonly affects young individuals and the mean age of the population is \u223c60 years, the costs associated with extended anticoagulation should not be forgotten. The costs of the drugs need to be balanced against health outcome costs associated with both recurrent VTE and bleeding.<\/jats:p>","DOI":"10.1182\/asheducation-2018.1.432","type":"journal-article","created":{"date-parts":[[2019,4,16]],"date-time":"2019-04-16T22:13:59Z","timestamp":1555452839000},"page":"432-438","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":30,"title":["Breadth of complications of long-term oral anticoagulant care"],"prefix":"10.1182","volume":"2018","author":[{"given":"Walter","family":"Ageno","sequence":"first","affiliation":[{"name":"Department of Medicine and Surgery, University of Insubria, Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Donadini","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Insubria, Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"234","reference":[{"issue":"10","key":"2019111521491271700_B1","doi-asserted-by":"crossref","first-page":"1580","DOI":"10.1111\/jth.12698","article-title":"Thrombosis: a major contributor to the global disease burden","volume":"12","author":"ISTH Steering Committee for World Thrombosis Day","year":"2014","journal-title":"J Thromb Haemost"},{"issue":"2","key":"2019111521491271700_B2","first-page":"255","article-title":"Epidemiology of first and recurrent venous thromboembolism: a population-based cohort study in patients without active cancer","volume":"112","author":"Martinez","year":"2014","journal-title":"Thromb Haemost"},{"issue":"1","key":"2019111521491271700_B3","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1160\/TH15-08-0686","article-title":"Epidemiology of first and recurrent venous thromboembolism in patients with active cancer. 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