Pranas Šerpytis, Sigita Glaveckaitė, Mindaugas Lizaitis
Abstract
Aim of the study. To determine risk factors for bleeding, major bleeding and death in patients with overdose of vitamin K antagonists. Methods. The retrospective study examined patients, who have overdosed vitamin K antagonists and were admitted to Vilnius university Santariškės hospital between 2010-01-01and 2016- 10-31. Age, sex and bleeding risk factors were compared between groups with bleeding events and without bleeding events. Results. Total of 518 patients’ data were analysed, 253 (48,8%) were men, 265 (51,2%) women, average age was 73,2±11,2 years old. 298 (57,5%) had bleeding event, 149 (50%) were women, average age was 72,3±11,7 years old. Group with bleeding event were more likely to have gastrointestinal bleeding history:16 (5,4%) vs. 3 (1,4%) (p=0,017. 162 patients had major bleeding, average age was 72,8±11,8 years old, 88 (54,3%) were women. Major bleeding group also had more common gastrointestinal bleeding history – 10 (6,2%) vs. 9 (2,5%) (p=0,04). 56 (10,8% ) patients died, average age was 74,8±11,2 years old, 27 (48,2%) were women . Patients with lethal outcomes had kidney disease history more often (creatinine was over 200mmol/l) -17 (30,4%) vs. 64 (13,9%) (p=0,001). Conclusions. Patients who had symptomic warfarin overdose with bleeding or major bleeding were more likely to have gastrointestinal bleeding history. 9,4% of all bleeding event were lethal. Patients who died during hospitalization and had warfarin overdose were more likely to have kidney diseases and creatinine value over 200 mmol/l. These risk factors might be prognostic to predict if warfarin overdose will be symptomic, but futher investigation is required.
Keyword(s): vitamin K antagonists; warfarin overdose; lethal bleeding; bleeding risk factors.
DOI: 10.5200/sm-hs.2017.047
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