Emergency Department Visits due to the Bleeding Complication of Warfarin

INTRODUCTION[|]Warfarin is an anticoagulant that is used in case of thromboembolism risk or events as a prophylactic or therapeutic agent. In this study, we investigated the emergency visits due to the bleeding complication of warfarin.[¤]METHODS[|]The patients admitted to emergency department with...

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Main Authors: Bahar Gülcay Çat, Umut Yücel Çavuş, Mesut Bakır, Duygu Yılmaz, Sinan Yıldırım
Format: Article
Language:English
Published: Turkish Foundation of Family Medicine 2020-04-01
Series:Anatolian Journal of Family Medicine
Subjects:
Online Access:https://www.journalagent.com/z4/download_fulltext.asp?pdir=anatoljfm&un=ANATOLJFM-25743
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spelling doaj-199d1245bfa44026826cefb925dd45302020-11-25T01:48:06ZengTurkish Foundation of Family MedicineAnatolian Journal of Family Medicine2651-34552020-04-0131596310.5505/anatoljfm.2019.25743ANATOLJFM-25743Emergency Department Visits due to the Bleeding Complication of WarfarinBahar Gülcay Çat0Umut Yücel Çavuş1Mesut Bakır2Duygu Yılmaz3Sinan Yıldırım4Department of Emergency Medicine, Mersin City Training and Research Hospital, Mersin, TurkeyDepartment of Emergency Medicine, Ankara Training and Research Hospital, Ankara, TurkeyDepartment of Anesthesiology, Division of Algology, Mersin University Faculty of Medicine, Mersin, TurkeyDepartment of Emergency Medicine, Manisa Turgutlu State Hospital, Manisa, TurkeyDepartment of Emergency Medicine, Canakkale State Hospital, Canakkale, TurkeyINTRODUCTION[|]Warfarin is an anticoagulant that is used in case of thromboembolism risk or events as a prophylactic or therapeutic agent. In this study, we investigated the emergency visits due to the bleeding complication of warfarin.[¤]METHODS[|]The patients admitted to emergency department with bleeding 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 this study 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 frequently observed 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%) and 97 (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).[¤]DISCUSSION AND 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 patients the importance of following the INR level regularly, especially in patients with co-morbid diseases.[¤]https://www.journalagent.com/z4/download_fulltext.asp?pdir=anatoljfm&un=ANATOLJFM-25743anticoagulantmortalitywarfarin
collection DOAJ
language English
format Article
sources DOAJ
author Bahar Gülcay Çat
Umut Yücel Çavuş
Mesut Bakır
Duygu Yılmaz
Sinan Yıldırım
spellingShingle Bahar Gülcay Çat
Umut Yücel Çavuş
Mesut Bakır
Duygu Yılmaz
Sinan Yıldırım
Emergency Department Visits due to the Bleeding Complication of Warfarin
Anatolian Journal of Family Medicine
anticoagulant
mortality
warfarin
author_facet Bahar Gülcay Çat
Umut Yücel Çavuş
Mesut Bakır
Duygu Yılmaz
Sinan Yıldırım
author_sort Bahar Gülcay Çat
title Emergency Department Visits due to the Bleeding Complication of Warfarin
title_short Emergency Department Visits due to the Bleeding Complication of Warfarin
title_full Emergency Department Visits due to the Bleeding Complication of Warfarin
title_fullStr Emergency Department Visits due to the Bleeding Complication of Warfarin
title_full_unstemmed Emergency Department Visits due to the Bleeding Complication of Warfarin
title_sort emergency department visits due to the bleeding complication of warfarin
publisher Turkish Foundation of Family Medicine
series Anatolian Journal of Family Medicine
issn 2651-3455
publishDate 2020-04-01
description INTRODUCTION[|]Warfarin is an anticoagulant that is used in case of thromboembolism risk or events as a prophylactic or therapeutic agent. In this study, we investigated the emergency visits due to the bleeding complication of warfarin.[¤]METHODS[|]The patients admitted to emergency department with bleeding 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 this study 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 frequently observed 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%) and 97 (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).[¤]DISCUSSION AND 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 patients the importance of following the INR level regularly, especially in patients with co-morbid diseases.[¤]
topic anticoagulant
mortality
warfarin
url https://www.journalagent.com/z4/download_fulltext.asp?pdir=anatoljfm&un=ANATOLJFM-25743
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