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Yeni nesil oral antikoagülanlar ile warfarin kullanan hastaların kanama komplikasyonu açısından karşılaştırılması: Beş yıllık inceleme

Comparison of new oral anticoagulants and warfarin in patients in terms of bleeding complication: A five-year review

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  1. Tez No: 654382
  2. Yazar: YUNUS DOĞAN
  3. Danışmanlar: PROF. DR. ÖZGÜR SÖĞÜT
  4. Tez Türü: Tıpta Uzmanlık
  5. Konular: Sağlık Eğitimi, İlk ve Acil Yardım, Health Education, Emergency and First Aid
  6. Anahtar Kelimeler: Belirtilmemiş.
  7. Yıl: 2021
  8. Dil: Türkçe
  9. Üniversite: Sağlık Bilimleri Üniversitesi
  10. Enstitü: İstanbul Haseki Eğitim ve Araştırma Hastanesi
  11. Ana Bilim Dalı: Acil Tıp Ana Bilim Dalı
  12. Bilim Dalı: Belirtilmemiş.
  13. Sayfa Sayısı: 48

Özet

Aim The aim of this retrospective study to analyze bleeding complications in patients admitted to the emergency department using oral anticoagulants and compare the rates of major or minor bleeding complications between NOAC and warfarin. Materials and Methods Among a total of 24,774 patients were examined who admitted to the emergency department between 01.01.2015 and 31.12.2019 with a diagnosis of non-traumatic bleeding. A total of 453 patients were included in the study who developed bleeding complications: 99 patients used NOAC and 354 patients used warfarin. Patients with major or minor bleeding due to NOAC and warfarin use were compared in terms of age, gender, comorbid diseases, bleeding type, and clinical outcome. Results In our study, we found 453 patients who developed bleeding complications: 354 patients used warfarin and 99 patients used NOAC. When the frequency of minor bleeding complications and gender were examined, there was no statistically significant difference between the groups using warfarin or NOAC. On the other hand, the mean age was found to be significantly higher in patients who developed minor bleeding due to NOAC use compared to patients who developed minor bleeding due to warfarin use. When the frequency of major bleeding complications and gender were examined, there was no statistically significant difference between the groups using warfarin or NOAC. On the other hand, the mean age was found to be significantly higher in patients who developed major bleeding due to NOAC use compared to patients who developed minor bleeding due to warfarin use. vii While there was no significant difference between patients using warfarin or NOAC in terms of major and fatal intracranial bleeding complication rates, relatively nonfatal gastrointestinal bleeding was observed to be significantly increased in the NOAC group compared to the warfarin group. Conclusion According to our data, although it has some differences all major and all minor bleeding complications in patients using NOAC have a similar bleeding rate compared to patients using warfarin. While warfarin has less risk than NOACs in terms of major and relatively non-fatal gastrointestinal bleeding, it can be said that it has a similar risk in terms of major and fatal intracranial bleeding. Keywords Bleeding complication, warfarin, NOAC

Özet (Çeviri)

Aim The aim of this retrospective study to analyze bleeding complications in patients admitted to the emergency department using oral anticoagulants and compare the rates of major or minor bleeding complications between NOAC and warfarin. Materials and Methods Among a total of 24,774 patients were examined who admitted to the emergency department between 01.01.2015 and 31.12.2019 with a diagnosis of non-traumatic bleeding. A total of 453 patients were included in the study who developed bleeding complications: 99 patients used NOAC and 354 patients used warfarin. Patients with major or minor bleeding due to NOAC and warfarin use were compared in terms of age, gender, comorbid diseases, bleeding type, and clinical outcome. Results In our study, we found 453 patients who developed bleeding complications: 354 patients used warfarin and 99 patients used NOAC. When the frequency of minor bleeding complications and gender were examined, there was no statistically significant difference between the groups using warfarin or NOAC. On the other hand, the mean age was found to be significantly higher in patients who developed minor bleeding due to NOAC use compared to patients who developed minor bleeding due to warfarin use. When the frequency of major bleeding complications and gender were examined, there was no statistically significant difference between the groups using warfarin or NOAC. On the other hand, the mean age was found to be significantly higher in patients who developed major bleeding due to NOAC use compared to patients who developed minor bleeding due to warfarin use. vii While there was no significant difference between patients using warfarin or NOAC in terms of major and fatal intracranial bleeding complication rates, relatively nonfatal gastrointestinal bleeding was observed to be significantly increased in the NOAC group compared to the warfarin group. Conclusion According to our data, although it has some differences all major and all minor bleeding complications in patients using NOAC have a similar bleeding rate compared to patients using warfarin. While warfarin has less risk than NOACs in terms of major and relatively non-fatal gastrointestinal bleeding, it can be said that it has a similar risk in terms of major and fatal intracranial bleeding. Keywords Bleeding complication, warfarin, NOAC

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