Hemorrhage during long-term anticoagulant drug therapy. 3. The relationship of minor to serious bleeding.

In a study of reports of 805 instances of spontaneous bleeding occurring among 2,189 patients receiving long-term anticoagulant drug therapy, 124 episodes were considered serious and 681 minor. There was no significant correlation of minor bleeding and serious bleeding. Minor bleeding unassociated with excessive reduction of coagulability or an underlying organic lesion could not be considered, according to this evidence, an indication for discontinuance of anticoagulant drug therapy. In apparently minor internal bleeding, however, hidden underlying organic lesions must be excluded. If gross hematuria occurs, renal lesions must be excluded. Rectal bleeding must not be considered minor until gastrointestinal lesions have been excluded.