Epidemiological features of warfarin overdose and efficacy of prothrombin complex concentrates

Authors : Mehmet ERDOĞAN, Harun AYHAN, Şahin ÇOLAK, Latif DURAN, Yücel YAVUZ, Hızır AKDEMİR, Fatma DOĞANÇ

Pages : 327-330

Doi:10.5835/jecm.omu.30.04.009

View : 47 | Download : 6

Publication Date : 2014-02-05

Article Type : Other Papers

Abstract :The aims of this study were to investigate the epidemiological features of warfarin overdose and evaluate the efficacy of prothrombin complex concentrate insert ignore into journalissuearticles values(PCC); for overdose treatment. The hospital records of 106 patients admitted to the emergency department insert ignore into journalissuearticles values(ED); for warfarin overdose during a two-year period were evaluated retrospectively. Demographic and epidemiological data as well as treatments were recorded. The data from 15 patients administered PCC were compared with those of other patients. The patient population consisted of 53 insert ignore into journalissuearticles values(50%); males and 53 insert ignore into journalissuearticles values(50%); females with a mean age of 70.2±14.5 years. Forty-five insert ignore into journalissuearticles values(42.4%); patients were admitted to the ED with bleeding disorders; 61 insert ignore into journalissuearticles values(57.6%); patients were admitted for other symptoms such as headache, syncope, trauma related injuries. Atrial fibrillation insert ignore into journalissuearticles values(n=50, 47.1%); was the most common indication for treatment with a vitamin K antagonist insert ignore into journalissuearticles values(VKA);. Other common indications were transient ischemic attack, stroke insert ignore into journalissuearticles values(n=43, 40.5%); and valvular heart disease insert ignore into journalissuearticles values(n=17, 16%);. Vitamin K was the preferred treatment for VKA reversal in 32 insert ignore into journalissuearticles values(30.2%); patients. Fresh-frozen plasma insert ignore into journalissuearticles values(FFP); was preferred in 23 insert ignore into journalissuearticles values(21.7%); patients. Fifteen insert ignore into journalissuearticles values(14.1%); patients required acute reversal of VKA with PCC. The anticoagulant drug was discontinued in 58 insert ignore into journalissuearticles values(54.7%); patients. Erythrocyte suspension insert ignore into journalissuearticles values(ES); and thrombocyte suspension insert ignore into journalissuearticles values(TS); transfusion rates were higher in the PCC-administered group; hospitalization rates were also higher in this group. ED length of stay insert ignore into journalissuearticles values(LOS); was shorter in this group. Initial international normalized ratio insert ignore into journalissuearticles values(INR); levels were significantly higher in the PCC group insert ignore into journalissuearticles values(5.68±3.74 versus 13.17±5.15);. As the elderly population increases, warfarin and VKArelated complications will be a more significant portion of ED practice.ED physicians should be experienced in acute reversal of VKA with PCC, and be familiar with the possible complications of FFP and PCC. J. Exp. Clin. Med., 2013; 30:327-330
Keywords : Fresh frozen plasma, prothrombin complex concentrate, vitamin K antagonist, warfarin overdose

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