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

Abstract

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)

Bleeding Complications in Warfarin-Treated Patients Admitted to the Emergency Department

“…In our study, the mean age of the patients was 64.9 ± 14.5 years and the rate of bleeding complications in those ≥ 65 years of age was 56.3%. However, while several studies have reported that advanced age is a risk factor for major bleeding [13, 16, 21, 22], this has not been consistently demonstrated [15, 17]. In our study, bleeding complications occurred in 26.2% of patients < 65 years of age and in 38.9% of patients ≥ 65 years of age.…”

“…Eroglu et al [12] reported that, among warfarin users seen in the hospital, bleeding most often occurs in the gastrointestinal system (38.5%) and especially in the upper gastrointestinal tract (n = 83). In the study of Sayhan et al [13], melena-hematochezia (16.9%), hematuria (14.6%), and cyanosis of the skin (10.1%) were the most common presenting complaints among patients admitted to the ED for warfarin-associated complications.…”

“…Anthony et al [14] identified atrial fibrillation (75.6%) and venous thromboembolic disease (14.9%) as the diseases for which the initiation of warfarin is most commonly indicated whereas according to Sayhan et al [13], atrial fibrillation (27%) and coronary artery disease (19.1%) are the most common underlying diagnoses among patients seen at the ED. In our study, the primary reasons for warfarin initiation were atrial fibrillation (59.4%) and stroke (16.7%).…”

Predictors of Hospitalization in Vitamin K Antagonist Users Presenting with Bleeding at the Emergency Department

“…These data are in line with other studies on the subject. 8,10,12,14,16,17 Gastrointestinal bleeding site was a predictor of hospitalization, probably due to its higher severity and the need for diagnostic or therapeutic endoscopic procedures.…”

“…In particular, studies reporting the prevalence and management of hemorrhagic complications (such as stroke) in emergency services are scarce, with high methodological heterogeneity. [10][11][12][13][14][15] To date, there is little knowledge about the reasons of hospitalization among these patients. Thus, this study aims to evaluate the Recommendations for conducting cross-sectional studies were followed according to the STROBE Statement (https://www.strobe-statement.org).…”