Bleedings caused by warfarin overdose

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Objectives: Warfarin is used in prophylaxis and treatment of many diseases. Low doses of warfarin increase risk of thrombosis and high doses increase risk of bleeding. In this study, we evaluated patients having warfarin-related bleedings in aspect of demographic data, duration of hospitalization, morbidity and mortality. Materials and methods: Between dates of January 2010 and December 2010, patients with history of using warfarin and complaint of bleeding, whose international normalized ratio (INR) values 6 or above, were evaluated retrospectively. Results: Twenty-three patients (64%) were female, and thirteen (36%) were male with a total number of 36 patients. The mean age is 67.5 years (range 43-84 year). Mean duration of drug use was 37.2 ± 49.7 months with a median value of 24 months. In six patients (16.7%), warfarin use was initiated for the first time, three (8.3%) was going to change a new dose. INR checks on a regular basis in 18 patients (50%) were achieved. Hematuria and hematemesis/melena were the most common forms of admission. Eleven patients (30%) had both erythrocyte (mean 3.8 units) and fresh frozen plasma transfusions. Thirty (83%) patients had fresh frozen plasma transfusions (mean 2.53 units), 19 of them had only fresh frozen plasma. Rate of mortality due to bleeding was 5,5%. The average of length of hospital stay was 3.28 days (range 1-8 days). Conclusions: Warfarin users need careful INR monitoring. Patients should be informed about importance of INR monitoring and potential complications.

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Warfarin , overdose , complication , hemorrhage

Dicle Medical Journal

226

Dicle Medical Journal