Patients with limited prognosis (expected to die within around six months) often have comorbidities requiring the use of anticoagulation (AC), including atrial fibrillation, history of embolic stroke, and venous thromboembolic (VTE) disease.1-3 Several studies have shown that the incidence of thromboembolism in these patients is as high as 50. At the same time, most of these patients are also at high risk for bleeding complications.2 To date, there are no consensus guidelines regarding when AC should be continued or discontinued in patients with limited prognosis.4-6 This critical decision remains challenging for providers seeking to optimize the quality of life (QoL) of patients since they must weigh the potential catastrophic complications associated with bleeding versus those associated with new thromboembolic events.7 This Fast Fact discusses factors informing the use of AC in these patients. AC for valvular disease has many unique considerations and is not discussed in this study.
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