No abstract

during three month period from 01/10/2014 to 31/12/2014 at Christchurch Hospital with atrial fibrillation. Patient data was collected from clinical notes and the electronic record. CHADS 2 VA 2 Sc and HASBLED scores were calculated independently for each patient.Results: Among 100 patients [Males 66%, average age of 69 (16-87) years, median length of stay 2 (IQR 1-5) days] 78% had a history of prior AF and 73 presented with "acute" AF as the primary diagnosis. CHADS 2 VA 2 Sc score was explicitly documented for twenty patients, while HASBLED score was documented for none. The median CHADS 2 VA 2 Sc score was 3 (IQR 2-4) and eighty patients had CHA 2 DS 2-VASc !2. Four patients with CHA 2 DS 2 VASc 1 were discharged on warfarin or dabigatran with no other indication for oral anticoagulation. Twenty-two patients did not receive oral anticoagulation despite CHADS 2 VA 2 Sc score of !2.Conclusion: The majority of patients received appropriate anticoagulation; however a significant proportion received inappropriate anticoagulation without clear explanation. Explicit documentation of CHADS 2 VA 2 Sc and HASBLED score was infrequent. Our findings compare favourably with international registries, but indicate there is room for improvement.http://dx.

Anticoagulant-related nephropathy (ARN) is a clinical syndrome of acute kidney injury in patients taking vitamin K antagonists or direct oral anticoagulants. It is associated with increased mortality and there is no specific treatment. We report the case of a 78-year-old man on dabigatran who developed macroscopic haematuria and acute kidney injury 2 weeks after mitral valve repair, reaching a peak creatinine of 415 µmol/L from a normal baseline, which was successfully treated with one course of idarucizumab. This case illustrates the efficacy of an anticoagulant reversal agent for the treatment of ARN.

No abstract

No abstract