Dergiler / The anatolian journal of family medicine (Online) / 2020 / Cilt: 3 - Sayı: 1

Emergency Department Visits due to the Bleeding Complication of Warfarin

Sayfa
59–63
DOI
—
🏛️Bu makalenin bibliyografik verileri ve tam metin bağlantısı DergiPark üzerinden sağlanmıştır.
DergiPark Kaydı ↗
✨

Yapay Zeka Hızlı Bakış & Çıkarımlar

AI Insight
⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

We should tell the patientsthe importance of following the INR level regularly, especially in patients with co-morbid diseases.

📌 3 Maddede Bu Makale

🎯
Amaç & Hipotez:Objectives: Warfarin is an anticoagulant that is used in case of thromboembolism risk or events as a prophylactic ortherapeutic agent.
📊
Temel Bulgular & Veri:In this study, we investigated the emergency visits due to the bleeding complication of warfarin.Methods: This study was performed at an Emergency Room a tertiary education and research hospital withannual emergency visits of nearly 300.000 patients.
💡
Sonuç & Katkı:We should tell the patientsthe importance of following the INR level regularly, especially in patients with co-morbid diseases.
🔬Tür:Araştırma Makalesi
📍Kapsam:Genişletilmiş Akademik Örneklem
⚙️Değişkenler:Alan Parametreleri

Özet

Objectives: Warfarin is an anticoagulant that is used in case of thromboembolism risk or events as a prophylactic ortherapeutic agent. In this study, we investigated the emergency visits due to the bleeding complication of warfarin.Methods: This study was performed at an Emergency Room a tertiary education and research hospital withannual emergency visits of nearly 300.000 patients. The patients admitted to emergency department withbleeding and using warfarin were included this study in a three year period. Age, gender, liver and kidney function tests, the time period of the warfarin use and the frequency of the control visits were recoded.Results: The patients admitted to emergency department with bleeding and using warfarin were included thisstudy in a three year period (n=243). The regular follow up of coagulation parameter was observed in 92 (42.8%)patients. One hundred six (43.6%) of the patients had had a bleeding complication before. The most frequentlyobserved bleeding region was urinary system (n=87, 35.8%). The INR level was greater than five in 223 (91.8%)of the patients. Fresh frozen plasma was used 193 (75.3%); prothrombin complex concentration was used in 15(6.2%) patients; conservative management was preferred in 45(18.5%) patients. Mortality rate was 22 (9.1%) and97 (39.9%) of the patients were discharged from emergency department without hospitalization. Female gender,low hemoglobin level, abnormal liver and kidney tests, INR level over 10 and irregular INR follow up were associated with both mortality and major bleeding (respectively; p=0.750, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001).Conclusion: The interaction with other medications or foods, bleeding complications, its requirement of regular follow up of coagulation parameters and dose adjustment make difficult its use. We should tell the patientsthe importance of following the INR level regularly, especially in patients with co-morbid diseases.

🔖

Bu Makaleye Atıf Yap

ÇAT, B., ÇAVUŞ, U., BAKIR, M., YILMAZ, D., YILDIRIM, S. (2020). Emergency Department Visits due to the Bleeding Complication of Warfarin. The anatolian journal of family medicine (Online), Cilt: 3 - Sayı: 1, 59–63. https://ajindex.com/articles/364992

📄 Tam Metin PDF Okuyucu

📄

PDF görüntüleyici hazırlanıyor...

Kaynakça (13)

  1. Czuprynska J, Patel JP, Arya R. Current challenges and future prospects in oral anticoagulant therapy. Br J Haematol 2017;178(6):838–51
  2. Harel Z, Chertow GM, Shah PS, Harel S, Dorian P, Yan AT, et al. Warfarin and the Risk of Stroke and Bleeding in Patients With Atrial Fibrillation Receiving Dialysis: A Systematic Review and Meta-analysis. Can J Cardiol 2017;33(6):737–46
  3. Massaro AR, Lip GYH. Stroke Prevention in Atrial Fibrillation: Focus on Latin America. Arq Bras Cardiol 2016;107:576–89
  4. Meltzer J, Guenzer JR. Anticoagulant Reversal and Anesthetic Considerations. Anesthesiol Clin 2017;35(2):191–205
  5. DeLoughery E, Avery B, DeLoughery TG. Retrospective study of rFVIIa, 4-factor PCC, and a rFVIIa and 3-factor PCC combination in improving bleeding outcomes in the warfarin and non-warfarin patient. Am J Hematol 2016;91(7):705–8
  6. Fanikos J, Grasso-Correnti N, Shah R, Kucher N, Goldhaber SZ. Major bleeding complications in a specialized anticoagulation service. Am J Cardiol 2005;96(4):595–8
  7. Baydın A, Nargıs C, Karataş D, Güven H, Doğanay Z, Yardan T. Retrospective evaluation of patients used warfarin admitted to emergency department. Turk J Emerg Med 2006;6:56–9
  8. Rivera-Caravaca JM, Roldán V, Esteve-Pastor MA, Valdés M, Vicente V, Lip GYH, et al. Cessation of oral anticoagulation is an important risk factor for stroke and mortality in atrial fibrillation patients. Thromb Haemost 2017;117(7):1448–54
  9. Melkonian M, Jarzebowski W, Pautas E, Siguret V, Belmin J, Lafuente-Lafuente C. Bleeding risk of antiplatelet drugs compared with oral anticoagulants in older patients with atrial fibrillation: a systematic review and meta-analysis. J Thromb Haemost 2017;15(7):1500–10
  10. Palareti G, Antonucci E, Migliaccio L, Erba N, Marongiu F, Pengo V, et al. Vitamin K antagonist therapy: changes in the treated populations and in management results in Italian anticoagulation clinics compared with those recorded 20 years ago. Intern Emerg Med 2017;12(8):1109–19
  11. Gomberg-Maitland M, Wenger NK, Feyzi J, Lengyel M, Volgman AS, Petersen P, et al. Anticoagulation in women with non-valvular atrial fibrillation in the stroke prevention using an oral thrombin inhibitor (SPORTIF) trials. Eur Heart J 2006;27(16):1947–53
  12. Beyth RJ, Quinn LM, Landefeld CS. Prospective evaluation of an index for predicting the risk of major bleeding in outpatients treated with warfarin. Am J Med 1998;105(2):91–9
  13. Shimomura A, Nagata N, Shimbo T, Sakurai T, Moriyasu S,