Patients at High Risk for Falls: A Reason Not to Anticoagulate?

Despite the proven benefits of oral anticoagulants in preventing and treating certain cardiovascular and cerebrovascular diseases, they are underprescribed. Fear of falls is the most commonly cited reason. Prior studies suggest that high fall risk should not be a contraindication to oral anticoagulant use, but these studies were limited by retrospective design or exclusion of patients at high risk for falls.

Researchers evaluated whether fall risk is associated with risk for major bleeding in a prospective study of 515 patients (median age, 71) who were treated with vitamin K antagonists at a hospital in Switzerland. Patients were considered to be at high risk for falls if they answered yes to either of two validated questions: (1) Did you f…