Publication: Varfarin kullanım öyküsü olan hastalarda, INR değerleriyle komplikasyon gelişim risk ilişkisinin ortaya konması
Abstract
Amaç: Günümüzde en çok kullanılan oral antikoagülan olan varfarinin doz aşımı durumunda ciddi komplikasyonlar çıkmaktadır. Bu çalışmada international normalized ratio (INR) düzeyleri ile varfarin komplikasyonları arasındaki ilişkinin incelenmesi amaçlanmıştır. Hastalar ve Yöntem: Bu araştırmada, Marmara Üniversitesi Tıp Fakültesi Hastanesi Acil Servisi nde Temmuz 2006 ve Temmuz 2007 tarihleri arasında varfarin kullanımına bağlı olduğu düşünülen şikayetlerle başvuran hastalar prospektif olarak incelendi. Varfarin kullanan bu hastaların, şikayet, takip planları ve sosyodemografik özellikleri analiz edildi. Analizlerde SPSS 15.0 programı kullanıldı. İstatistiksel analiz için ki-kare testi kullanıldı. Farkı p<0,05 olan değerler istatistiksel olarak anlamlı kabul edildi. Bulgular: Çalışma dönemi içinde INR yüksekliği bulunan 105 hastanın değerlendirmesinin acil serviste yapıldığı saptandı. Kanaması olan bu hastaların %45,7sinin acile başvuru süresi 12 saatten kısa idi. Tüm hastalardaki serum INR değerleri bakıldığında, %30,4ü 10,0unun üstünde, %21,9unda ise 3,5 ve altında idi. Tüm hastalar içinde 2 hastaya yoğun bakım ünitesi takip ve tedavisi gerekti. INR değerleri ile kanama riski arasında bir ilişki saptanmadı (p>0,05). Sonuç: INR değeri ile kanamanın ciddiyeti arasında belirgin korelasyon olmadığı saptanmıştır (p>0,05). (Marmara Üniversitesi Tıp Fakültesi Dergisi 2012;25:138-42)
Objective: Warfarin is the most commonly used oral anticoagulant agent. In overdose situations, serious complications may occur. The aim of the study was to determine the correlation between the international normalized ratio (INR) levels and complications due to warfarin. Patients and Methods: The study was performed prospectively at the Department of Emergency Medicine, Marmara University Hospital between July 2006 and July 2007. Patients whose complaints were due to warfarin overdose were included in the study. The presentations and outcomes of these patients were analyzed. SPSS 15.0 was used for the analysis. The Chisquare test was used for the statistical analysis. The statistical difference p<0.05 is considered as significant. Results: During the study period, 105 patients with high INR levels were evaluated in the emergency department. 45.7% of these patients presented to the Emergency Service in less than 12 hours. INR levels were over 10.0 in 30.4%, and below 3.5 in 21.9% of the patients. 2 patients had to stay in the intensive care unit for following and treatment. There was no correlation between the INR levels and the bleeding risk (p>0.05). Conclusion: There is no significant correlation between the INR levels and the severity of the bleeding (p>0.05). (Marmara Medical Journal 2012;25:138-42)
Objective: Warfarin is the most commonly used oral anticoagulant agent. In overdose situations, serious complications may occur. The aim of the study was to determine the correlation between the international normalized ratio (INR) levels and complications due to warfarin. Patients and Methods: The study was performed prospectively at the Department of Emergency Medicine, Marmara University Hospital between July 2006 and July 2007. Patients whose complaints were due to warfarin overdose were included in the study. The presentations and outcomes of these patients were analyzed. SPSS 15.0 was used for the analysis. The Chisquare test was used for the statistical analysis. The statistical difference p<0.05 is considered as significant. Results: During the study period, 105 patients with high INR levels were evaluated in the emergency department. 45.7% of these patients presented to the Emergency Service in less than 12 hours. INR levels were over 10.0 in 30.4%, and below 3.5 in 21.9% of the patients. 2 patients had to stay in the intensive care unit for following and treatment. There was no correlation between the INR levels and the bleeding risk (p>0.05). Conclusion: There is no significant correlation between the INR levels and the severity of the bleeding (p>0.05). (Marmara Medical Journal 2012;25:138-42)