Demographic Analysis of Complications of Warfarin Treatment and Factors Affecting Mortality

Objective: This study investigated the demographic analysis of complications of warfarin therapy and the factors affecting mortality. Material and Methods: The digital medical records of patients who applied to our Emergency Clinic with warfarin overdose between September 2007 and September 2010 were retrieved and patient files were assessed retrospectively. Cases were classified into two groups in terms of INR level and hemorrhagic complications; patients with an INR level greater than 3.5 and a hemorrhagic complication, and patients with an INR level greater than 3.5 and no hemorrhagic complication. Furthermore, cases with a hemorrhagic complication were divided into two subgroups as those who died and those who survived. Results: The study enrolled 151 cases presenting to our emergency clinic with warfarin overdose. Among these, 50.3% (n=76) were males and 49.7% (n=75) were females. Mean age was 60.80±16.11 years. There was no significant difference between the groups in terms of sex and age. Hemorrhagic complication was present in 66.89% (n=101) while absent in 33.11% (n=50). PT and INR levels were significantly higher in patients with hemorrhage compared to those without (for PT 90.98±26.52 vs. 55.51±12.70, respectively; p<0.001; for INR 8.97±11.29 vs. 4.63±0.68, respectively; p=0.042). In patients with a hemorrhagic complication who died, the PT level was significantly higher, and hematocrit and platelet levels were significantly lower than those of patients who survived a hemorrhagic complication (p<0.001, p=0.033, and p=0.009, respectively). Conclusion: Education in warfarin use, regular follow-ups, self-monitorization, and increased distribution of home-type coagulometry devices will decrease the frequency of complications. (JAEM 2013; 12: 139-44)