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Bleeding complications related to warfarin treatment: a descriptive register study from the anticoagulation clinic at Helsingborg Hospital

Navgren, Monica ; Forsblad, Johan and Wieloch, Mattias LU (2014) In Journal of Thrombosis and Thrombolysis 38(1). p.98-104
Abstract
The most common indication for treatment with warfarin is the prevention of ischemic stroke in patients with atrial fibrillation. Time in therapeutic range (TTR) is an important tool to evaluate the quality of anticoagulation treatment. The aim of this study was to investigate the quality of treatment and the incidence of bleeding complications in patients on warfarin treatment treated by the anticoagulation clinic in Helsingborg. This is the first study that has specifically focused on the spontaneous reporting of bleeding complications in a real-world population. A total of 4,400 patients with a total of 8,394 patient years were registered, in the database Journalia AVK, during the time period November 1, 2007 to November 1, 2010. The... (More)
The most common indication for treatment with warfarin is the prevention of ischemic stroke in patients with atrial fibrillation. Time in therapeutic range (TTR) is an important tool to evaluate the quality of anticoagulation treatment. The aim of this study was to investigate the quality of treatment and the incidence of bleeding complications in patients on warfarin treatment treated by the anticoagulation clinic in Helsingborg. This is the first study that has specifically focused on the spontaneous reporting of bleeding complications in a real-world population. A total of 4,400 patients with a total of 8,394 patient years were registered, in the database Journalia AVK, during the time period November 1, 2007 to November 1, 2010. The mean age was 72 years. TTR was 73.3 % for the whole population. 421 patients suffered from haemorrhagic events. The frequency of major and fatal bleedings and intracranial haemorrhage (ICH) were 1.6, 0.2 and 0.5 % per patient-year, respectively. A correlation between age and severe bleeding (major, fatal and ICH) (p = 0.003) was seen, but no correlation between gender and severe bleeding (p = 0.27). In 60 out of 455 bleeding events the complication had been reported to the anticoagulation clinic. At the anticoagulation clinic in Helsingborg the quality of warfarin treatment is good compared to previous results described in the literature, with regards to bleeding complications and efficacy. However, in our study, we confirm that the spontaneous reporting of bleeding complications related to warfarin is inadequate, and that review of patient records is needed to assure proper follow-up. (Less)
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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Warfarin, TTR, Atrial fibrillation, Spontaneous reporting, Bleeding, complications
in
Journal of Thrombosis and Thrombolysis
volume
38
issue
1
pages
98 - 104
publisher
Springer
external identifiers
  • wos:000337053800017
  • scopus:84902363873
ISSN
1573-742X
DOI
10.1007/s11239-013-1011-z
language
English
LU publication?
yes
id
a7523d3f-f927-489b-9620-e41cf76fdd4c (old id 4549086)
date added to LUP
2016-04-01 14:59:37
date last changed
2022-01-28 03:26:44
@article{a7523d3f-f927-489b-9620-e41cf76fdd4c,
  abstract     = {{The most common indication for treatment with warfarin is the prevention of ischemic stroke in patients with atrial fibrillation. Time in therapeutic range (TTR) is an important tool to evaluate the quality of anticoagulation treatment. The aim of this study was to investigate the quality of treatment and the incidence of bleeding complications in patients on warfarin treatment treated by the anticoagulation clinic in Helsingborg. This is the first study that has specifically focused on the spontaneous reporting of bleeding complications in a real-world population. A total of 4,400 patients with a total of 8,394 patient years were registered, in the database Journalia AVK, during the time period November 1, 2007 to November 1, 2010. The mean age was 72 years. TTR was 73.3 % for the whole population. 421 patients suffered from haemorrhagic events. The frequency of major and fatal bleedings and intracranial haemorrhage (ICH) were 1.6, 0.2 and 0.5 % per patient-year, respectively. A correlation between age and severe bleeding (major, fatal and ICH) (p = 0.003) was seen, but no correlation between gender and severe bleeding (p = 0.27). In 60 out of 455 bleeding events the complication had been reported to the anticoagulation clinic. At the anticoagulation clinic in Helsingborg the quality of warfarin treatment is good compared to previous results described in the literature, with regards to bleeding complications and efficacy. However, in our study, we confirm that the spontaneous reporting of bleeding complications related to warfarin is inadequate, and that review of patient records is needed to assure proper follow-up.}},
  author       = {{Navgren, Monica and Forsblad, Johan and Wieloch, Mattias}},
  issn         = {{1573-742X}},
  keywords     = {{Warfarin; TTR; Atrial fibrillation; Spontaneous reporting; Bleeding; complications}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{98--104}},
  publisher    = {{Springer}},
  series       = {{Journal of Thrombosis and Thrombolysis}},
  title        = {{Bleeding complications related to warfarin treatment: a descriptive register study from the anticoagulation clinic at Helsingborg Hospital}},
  url          = {{http://dx.doi.org/10.1007/s11239-013-1011-z}},
  doi          = {{10.1007/s11239-013-1011-z}},
  volume       = {{38}},
  year         = {{2014}},
}