This retrospective observational study examined clinical and therapeutic factors associated with clinically relevant bleeding (per ISTH criteria) in 1,377 anticoagulated adults (VKA or DOAC) followed in primary care centers in Badalona, Spain, during 2024.
Bleeding occurred in 29 patients (2.1%; 95% CI: 1.5–3.0). In multivariable analysis (n=986 complete cases), only age was independently associated with bleeding (adjusted OR 1.08 per year; 95% CI: 1.02–1.14; p=0.006). Patients who bled were older (83.9 vs 76.3 years), had lower eGFR (57.6 vs 68.1 ml/min/1.73m²), more CKD (56.0% vs 32.6%), and more hospital admissions (0.91 vs 0.25).
Only 29 bleeding events occurred, making the logistic regression underpowered and results exploratory. Renal function data were incomplete, restricting full multivariable analysis to 986 of 1,377 patients. The single-year, single-network retrospective design limits generalizability.
In anticoagulated primary care patients, increasing age is the strongest independent predictor of clinically relevant bleeding—each additional year raises the odds by ~8%. Clinicians should apply heightened vigilance and individualized risk-benefit reassessment for older anticoagulated patients, particularly those with CKD or frequent hospitalizations.
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