Bleedings caused by warfarin overdose

• Main Authors: Orhan Alimoğlu, Müjgan Çalışkan, Tolga Canbak, Fatih Başak, Mustafa Hasbahçeci, Aylin Acar
• Format: Article
• Language: English
• Published: Dicle University Medical School 2012-06-01
• Series: Dicle Medical Journal
• Subjects: Warfarin; overdose; complication; hemorrhage
• Online Access: http://www.diclemedj.org/upload/sayi/2/DicleMedJ-01048.pdf
• ISSN: 1300-2945; 1308-9889

Objectives: Warfarin is used in prophylaxis and treatmentof many diseases. Low doses of warfarin increaserisk of thrombosis and high doses increase risk of bleeding.In this study, we evaluated patients having warfarinrelatedbleedings in aspect of demographic data, durationof hospitalization, morbidity and mortality.Materials and methods: Between dates of January2010 and December 2010, patients with history of usingwarfarin and complaint of bleeding, whose internationalnormalized ratio (INR) values 6 or above, were evaluatedretrospectively.Results: Twenty-three patients (64%) were female, andthirteen (36%) were male with a total number of 36 patients.The mean age is 67.5 years (range 43-84 year).Mean duration of drug use was 37.2 ± 49.7 months with amedian value of 24 months. In six patients (16.7%), warfarinuse was initiated for the first time, three (8.3%) wasgoing to change a new dose. INR checks on a regularbasis in 18 patients (50%) were achieved.Hematuria and hematemesis/melena were the mostcommon forms of admission. Eleven patients (30%) hadboth erythrocyte (mean 3.8 units) and fresh frozen plasmatransfusions. Thirty (83%) patients had fresh frozenplasma transfusions (mean 2.53 units), 19 of them hadonly fresh frozen plasma. Rate of mortality due to bleedingwas 5,5%. The average of length of hospital stay was3.28 days (range 1-8 days).Conclusions: Warfarin users need careful INR monitoring.Patients should be informed about importance of INRmonitoring and potential complications.