Abstract 40 Complications of warfarin therapy and the correlation of the outcomes with international normalized ratio levels

Denizbaşı, Arzu; Ünlüer, Erden Erol; Güneysel, Özlem; Eroğlu, Serkan Emre; Kosargelir, Mehmet

doi:10.1097/00063110-200602000-00017

Cited by 8 publications

(17 citation statements)

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“…Correspondingly, many studies in the literature have reported the most frequent bleeding site to be the gastrointestinal system (8,18,19). In this study, we observed that bleeding occurred most frequently in the gastrointestinal system in the form of upper gastrointestinal system bleeding.…”

Section: Discussionsupporting

confidence: 51%

“…Denizbasi et al (18) have reported that they found no significant correlations between the severity and results of bleeding and INR levels. Levine et al (4) have similarly reported that major bleeding occurred frequently, even if prothrombin time was within the therapeutic range, and asserted that there was no clear correlation between major bleeding or bleeding rates and the anticoagulant effect.…”

Section: Discussionmentioning

confidence: 97%

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The Analysis of Patients Admitted to the Emergency Department Due to Complications Related to Warfarin Treatment

Sayhan¹,

Oguz²,

Yüksel³

et al. 2014

JAEM

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Objective: Warfarin is the most commonly used oral anticoagulant around the world. The most important complication of warfarin is bleeding. This study was conducted to evaluate the patients who were admitted to our emergency department due to complications related to warfarin treatment. Material and Methods:Eighty-nine patients (32 females, 57 males) were enrolled into this retrospective study. The patients were evaluated according to their age, gender, duration of therapy (year), co-administered drugs, bleeding localization, treatments, amount of blood transfusions, duration of bleeding, initial and after-treatment PT, INR, complete blood count, and aPTT.Results: Mean duration of anticoagulant use was 3.05±2.87 years. The most common indication of warfarin was atrial fibrillation. The most frequent bleeding localization was the upper gastrointestinal tract. Thirty-four (38.2%) of the patients had major bleeding, and 55 (61.8%) had minor bleeding. Age, co-administered drugs, amount of erythrocyte suspension transfusion, presence of previous warfarin overdose history, Hb levels at admission, and duration of follow-up in the ED were different between the bleeding types. Conclusion:In this study, we found that the bleeding complications of warfarin were associated with the aged population, presence of previous warfarin overdose history, and concomitant drug use. (JAEM 2014; 13: 194-8)

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Section: Discussionsupporting

confidence: 51%

Section: Discussionmentioning

confidence: 97%

The Analysis of Patients Admitted to the Emergency Department Due to Complications Related to Warfarin Treatment

Sayhan¹,

Oguz²,

Yüksel³

et al. 2014

JAEM

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“…Bununla birlikte bazı çalışmalar varfarine bağlı koagülopatisi olan ancak kanaması olmayan vakaların takibinde kanama riski açısından yüksek INR'nin belirteç olarak kullanılmasını tavsiye etmektedir. [8,9] INR düzeylerinin kanama ciddiyeti ile ilişkisinin zayıf olduğu-nu bildiren literatürde çeşitli çalışmalar bulunmaktadır. [9][10][11] Denizbaşı ve ark.…”

Section: Discussionunclassified

The Analysis of Cases Admitted to Intensive Care Units from Emergency Department Due to Complications Related to Warfarin Treatment

et al. 2011

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ÖZET AmaçVarfarin tedavisine bağlı komplikasyonlar nedeniyle başvuran olguların pek çoğu acil serviste başarı ile tedavi edilmekte, sadece küçük bir grupta yoğun bakıma yatış gerekli olmaktadır. Çalışma-mızda yoğun bakıma yatışı gereken bu grubun demografik ve klinik özelliklerini ortaya koymayı amaçladık. Gereç ve YöntemAcil servisimize başvuran varfarin tedavisine bağlı komplikasyonlar nedeniyle yoğun bakıma yatışı gerekli görülen 30 hastanın kayıtları retrospektif olarak incelendi. Hastalar yaş, cinsiyet, kanama bölgesi, komorbid hastalıklar, International Normalized Ratio (INR) düzeyleri, uygulanan tedaviler ve sonuçlar açısından değer-lendirildi. BulgularHastaların yaş ortalaması 66.9±12 idi; %57'si kadındı. Hastaların %80'i (n=24) 2 ve üstünde komorbid hastalığı mevcuttu. Ortalama INR düzeyi 9.46 olarak saptandı. INR düzeyi 5 hastada (%16.6) 5'in altında, 11 hastada (%36.6) 5-9 arasında, 14 hastada (%46.6) ise INR düzeyi 9-18 arasında saptandı. Kanama bölgesi en sık olarak 13 hastada (%43) gastrointestinal sistemde, 8 hastada (%26) genitoü-riner sistemde gözlendi. Hastaların 25'ine (%83) intravenöz K vitamini, 23'üne (%76) TDP (taze donmuş plazma), 13'üne (%43) eritrosit süspansiyonu tedavisi uygulanmıştı. İki olgunun ölümcül seyrettiği (%6.6) gözlendi, bu olguların sırasıyla INR değerleri 7.92 ve 7.15 idi. En sık gastrointestinal ve genitoüriner sistem kanamaları görül-mektedir. Yoğun bakıma yatışı yapılan hastaların önemli bir kısmın-da K vitamini ve TDP kullanımına ihtiyaç duyulmuştur. INR düzeyle-ri ve mortalite arasında belirgin bir ilişki gözlenmemiştir. SonuçSonuç olarak, kanamanın yanında ileri yaş, komorbid hastalık ve yüksek INR düzeyleri de yoğun bakıma yatış kararı üzerinde etkili faktörler gibi görünmektedir.Anahtar sözcükler: Antikoagülasyon; kanama; varfarin; yoğun bakım. SUMMARY Objectives Most of cases that present to the emergency departments (EDs) due to complications related to warfarin therapy are successfully treated in the ED, except only for a small group for which admission to the intensive care units (ICUs) is required. In our study, we aimed to introduce the demographic and clinical characteristics of this group needed to ICU admission. Methods The records of 30 patients who presented to the Gulhane Military Medical Academy ED (Ankara, Turkey) and required admission to ICU due to the complications related to warfarin therapy were retrospectively reviewed. Patients were evaluated according to age, sex, bleeding region, comorbid diseases, INR (International Normalized Ratio) levels, treatments and outcomes. Results Average

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“…The rate of major bleeding in Turkey was reported as 21.6% (Unverir et al, 2006). The authors commented the high incidence of major bleeding episodes in Turkey could be attributed to social and cultural diversity, difficulties in follow-up of bleeding profiles and genetic factors (Denizbas et al, 2006;Unverir et al, 2006). Our case was a 64 year-old woman and was under anticoagulant therapy for a long time.…”

Section: Discussionmentioning

confidence: 99%

Rectus Sheath Hemorrhage Due To Oral Antıcoagulant Therapy

BAYDIN¹,

Ekiz²,

YARDAN³

et al. 2009

jecm

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Rectus sheath hemorrhage (RSH) is an uncommon condition characterized by abdominal pain. It is an accumulation of blood in the sheath of the rectus abdominis muscle, secondary to rupture of an epigastric vessel or muscle tear. It is usually located infraumblically and often misdiagnosed as acute abdomen. This case report describes a patient with RSH and retroperitoneal hemorrhage due to anticoagulant therapy, who was admitted to our Emergency Department with complaints of abdominal pain, emesis, nausea, and abdominal wall ecchymosis. Computerized tomography must be chosen for diagnosis. Main therapy is conservative management.

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Abstract 40 Complications of warfarin therapy and the correlation of the outcomes with international normalized ratio levels

Cited by 8 publications

References 0 publications

The Analysis of Patients Admitted to the Emergency Department Due to Complications Related to Warfarin Treatment

The Analysis of Patients Admitted to the Emergency Department Due to Complications Related to Warfarin Treatment

The Analysis of Cases Admitted to Intensive Care Units from Emergency Department Due to Complications Related to Warfarin Treatment

Rectus Sheath Hemorrhage Due To Oral Antıcoagulant Therapy

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