Key result
High INR levels (>5.0) in patients on warfarin were significantly associated with a higher requirement for medical treatment, including fresh frozen plasma and vitamin K, compared to lower INR levels.
Why the study?
Bleeding risk rises significantly at INR values above 4.5 during long-term warfarin therapy, prompting evaluation of the management of warfarin-related bleeding complications in acute care patients.
Cross-Sectional (n=74)
No
In the emergency department, warfarin anticoagulation with high INR but without bleeding can be safely managed conservatively, while major bleeding with high INR requires fresh frozen plasma and intravenous vitamin K.
Background: Bleeding is the risk related to long-term warfarin therapy and rises significantly at INR values above 4.5. The goal of warfarin reversal is to elevate vitamin Kdependent clotting factors. The aim of this study was to evaluate the management of the warfarin related bleeding complications in acute care patients. Material and Method: A totally of 74 patients with on warfarin treatment, who admitted to our acute care clinic were enrolled to the study. The patients were grouped into three groups based on International normalized ratio (INR) levels. INR levels of the groups were <3.0 for Group-I, 3.0INR 5.0 for Group-II and INR>5.0 for Group-III. Patients' medical history, medications and warfarin related complications were recorded throughout examination. Results: In hematological analysis, platelet count and mean platelet volume were similar between groups. Plateletcrit and hemoglobin levels were significantly higher in group-I than group-III (p=0.01). There was no significance difference between groups in blood group analysis. Group-I and group-II were evaluated without medical intervention yet fresh frozen plasma (FFP) and erythrocyte suspension (ES) were given significantly in group-III. Patients in group-I and group-II were discharged usually, and group-III subjects were followed-up in the hospital.
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Özdemir et al. (2020) conducted a cross-sectional in Warfarin-related bleeding complications (n=74). High INR levels (INR > 5.0) vs. Lower INR levels (INR < 3.0 and 3.0-5.0) was evaluated on Requirement for medical treatment (e.g., FFP, Vitamin K, or erythrocyte suspension) (p=<0.01). High INR levels (>5.0) in patients on warfarin were significantly associated with a higher requirement for medical treatment, including fresh frozen plasma and vitamin K, compared to lower INR levels.
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