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-  2020 

BLEEDING AS A MAJOR CAUSE OF EMERGENCY ATTENDANCE IN PATIENTS ON DIFFERENT ORAL ANTICOAGULANTS

Keywords: anticoagulant therapy, bleeding, emergency department, chronic kidney disease

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Abstract:

Sa?etak Background: Anticoagulant therapy is increasingly used in the world because the population is getting older and conditions that require anticoagulant treatment are more frequent. Since bleeding occurs in patients taking warfarin, as well as in patients taking direct oral anticoagulants, the goal of this study was to determine whether there was a difference in the frequency of bleeding as a major cause of emergency attendance between these two groups. Methods: The study included 83 patients examined in Emergency Unit, Merkur University Hospital from December 1, 2018 until June 1, 2019, who were taking anticoagulant therapy and had chronic kidney disease (stage 2-4). Group A included 22 patients (8 male) using warfarin and group B included 61 patients (19 male) taking direct oral anticoagulants. The median age was 80.77 years in group A and 80.95 years in group B. There were no differences in comorbidities. Doses of anticoagulants were adjusted to the glomerular ? ltration rate. Results: In group A, the main cause of emergency attendance was bleeding (mostly gastrointestinal) in 15 (68.18%) group A patients, whereas in group B bleeding was the main cause in 21 (34.42%) patients. The χ2-test was used to assess difference in the frequency of bleeding as the cause of emergency attendance (χ2=7.501; p<0.01). Conclusion: Study ? ndings suggested that patients using direct oral anticoagulants as anticoagulant therapy adjusted to renal function had signi? cantly less bleeding as the cause of attendance at Emergency Unit as compared to patients taking warfarin

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