Disability After Clinically Significant Extracranial Bleeding

In the ASPREE trial (NEJM JW Gen Med Oct 15 2018 and N Engl J Med 2018; 379:1509), low-dose aspirin raised risk for bleeding but did not prevent disability or cardiovascular events in healthy older adults (median age, 74). Now, in a secondary analysis of this study, researchers examine the association between major extracranial bleeding — defined as bleeding at any site other than brain or spinal cord that required hospital stay >24 hours, red blood cell transfusion, or surgery for hemostasis or that resulted in death — and development of functional disability.

In the original ASPREE trial, major extracranial bleeding occurred more commonly in aspirin recipients than placebo recipients (≈3% vs. ≈2%). In this analysis, persistent dependence i…