E-ISSN 2651-3455 (Online) | ISSN 2630-5593 (Print)
The Anatolian Journal of Family Medicine Emergency Department Visits due to the Bleeding Complication of Warfarin [anatol j fm]
anatol j fm. 2020; 3(1): 59-63 | DOI: 10.5505/anatoljfm.2019.25743

Emergency Department Visits due to the Bleeding Complication of Warfarin

Bahar Gülcay Çat1, Umut Yücel Çavuş2, Mesut Bakır3, Duygu Yılmaz4, Sinan Yıldırım5
1Department of Emergency Medicine, Mersin City Training and Research Hospital, Mersin, Turkey
2Department of Emergency Medicine, Ankara Training and Research Hospital, Ankara, Turkey
3Department of Anesthesiology, Division of Algology, Mersin University Faculty of Medicine, Mersin, Turkey
4Department of Emergency Medicine, Manisa Turgutlu State Hospital, Manisa, Turkey
5Department of Emergency Medicine, Canakkale State Hospital, Canakkale, Turkey

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.

Keywords: Anticoagulant, mortality, warfarin

Bahar Gülcay Çat, Umut Yücel Çavuş, Mesut Bakır, Duygu Yılmaz, Sinan Yıldırım. Emergency Department Visits due to the Bleeding Complication of Warfarin. anatol j fm. 2020; 3(1): 59-63

Corresponding Author: Bahar Gülcay Çat, Türkiye
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