Outcomes and Resource Utilization After Anticoagulant-Related Bleeding in Chronic Kidney Disease (ORACLE-CKD)
Co-applicant(s): Manish Sood, Marc Carrier, Tzu-Fei Michelle Wang
Lay Abstract
The ORACLE-CKD Study Chronic kidney disease (CKD) affects about 4 million Canadians and 37 million Americans. People with CKD are more likely to develop cardiovascular diseases such as atrial fibrillation (irregular heartbeat that can lead to stroke) and venous thromboembolism (blood clots in the veins) that are treated with blood thinners, also called oral anticoagulants. While these medicines help prevent strokes and blood clots, they can also cause serious bleeding. This risk is especially high in people with kidney disease, but little is known about what happens to patients after such bleeding events. Our study will look at adults in Region: Ontario, aged 66 and older, who were hospitalized for serious bleeding while taking oral anticoagulants. We will compare outcomes between people with different severity of kidney disease, from mild to severe.
We will study three main questions:
1. What kinds of bleeding events occur, and what healthcare resources are used during and after the hospital stay?
2. How does kidney disease severity affect outcomes such as death, repeat bleeding, or new blood clots?
3. How often are oral anticoagulants restarted after bleeding, and what happens to patients who restart or don't restart oral anticoagulants?
We will use Region: Ontario health databases to follow patients for one year after their hospital stay. We will track health outcomes, hospital visits, surgeries, and other key measures. By understanding how kidney disease affects recovery from major bleeding on oral anticoagulants, this research will help doctors and patients make better decisions about treatment and find ways to improve care for this vulnerable group.
