Which condition is a contraindication for the use of rivaroxaban during hospital admission for VTE?

Rivaroxaban is an anticoagulant used for the treatment and prevention of venous thromboembolism (VTE). A contraindication for the use of rivaroxaban includes certain conditions that increase the risk of bleeding or that may compromise the effectiveness of the therapy.

In this case, recent bronchiectasis poses a significant concern. Bronchiectasis is a chronic condition characterized by permanent enlargement of the airways, which can lead to a chronic cough and recurrent respiratory infections. Patients with bronchiectasis may have underlying disturbances in their coagulation status or increased susceptibility to bleeding due to recurrent infections or inflammation in the lung tissue. The risk of adverse outcomes, such as bleeding complications, is heightened when using anticoagulants like rivaroxaban in these patients.

The other listed conditions do not pose the same level of contraindication. A history of major surgery may require careful consideration but is not an absolute contraindication if the surgery has fully healed and bleeding risk is assessable. Stable ischemic heart disease requires monitoring but does not inherently preclude the use of rivaroxaban. Increased age is a risk factor that necessitates caution but does not categorically contraindicate anticoagulation therapy.

Understanding the implications of the conditions on the