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BLEEDING AS A MAJOR CAUSE OF EMERGENCY ATTENDANCE IN PATIENTS ON DIFFERENT ORAL ANTICOAGULANTS
INGRID PRKAČIN
orcid.org/0000-0002-5830-7131
; Merkur University Hospital, Department of Internal Medicine, Emergency Unit, Zagreb, University of Zagreb, School of Medicine, Zagreb, Croatia
JURAJ JUG
; University of Zagreb, School of Medicine, Zagreb, Croatia
TOMO SVAGUŠA
; University of Zagreb, School of Medicine, Dubrava University Hospital, Department of Internal Medicine, Zagreb, Croatia
PETRA PERVAN
; University of Zagreb, School of Medicine, Zagreb, Croatia
VIŠNJA NESEK ADAM
; Sveti Duh University Hospital, Department of Anesthesiology, Resuscitation and Intensive Care, Zagreb and J. J. Strossmayer University in Osijek, Faculty of Medicine, Osijek, Croatia
Abstract
Background: Anticoagulant therapy is increasingly used in the world because the population is getting older and conditions that require anticoagulant treatment are more frequent. Since bleeding occurs in patients taking warfarin, as well as in patients taking direct oral anticoagulants, the goal of this study was to determine whether there was a difference in the frequency of bleeding as a major cause of emergency attendance between these two groups. Methods: The study included 83 patients examined in Emergency Unit, Merkur University Hospital from December 1, 2018 until June 1, 2019, who were taking anticoagulant therapy and had chronic kidney disease (stage 2-4). Group A included 22 patients (8 male) using warfarin and group B included 61 patients (19 male) taking direct oral anticoagulants. The median age was 80.77 years in group A and 80.95 years in group B. There were no differences in comorbidities. Doses of anticoagulants were adjusted to the glomerular fi ltration rate. Results: In group A, the main cause of emergency attendance was bleeding (mostly gastrointestinal) in 15 (68.18%) group A patients, whereas in group B bleeding was the main cause in 21 (34.42%) patients. The χ2-test was used to assess difference in the frequency of bleeding as the cause of emergency attendance (χ2=7.501; p<0.01). Conclusion: Study fi ndings suggested that patients using direct oral anticoagulants as anticoagulant therapy adjusted to renal function had signifi cantly less bleeding as the cause of attendance at Emergency Unit as compared to patients taking warfarin.
Keywords
anticoagulant therapy; bleeding; emergency department; chronic kidney disease
Hrčak ID:
235755
URI
Publication date:
16.3.2020.
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