Warfarin prevalence, indications for use and haemorrhagic events

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dc.contributor.author Quirke, William
dc.contributor.author Cahill, Mary R.
dc.contributor.author Perera, Kanthi
dc.contributor.author Sargent, Jeremy
dc.contributor.author Conway, Jane
dc.date.accessioned 2011-11-28T17:07:05Z
dc.date.available 2011-11-28T17:07:05Z
dc.date.issued 2007-03
dc.identifier.citation Ouirke, W.;Cahill, M.R.;Perera, K.;Sargent, J.;Conway, J. (2007) 'Warfarin prevalence, indications for use and haemorrhagic events'. Irish Medical Journal, 100 (3):402-404. en
dc.identifier.volume 100 en
dc.identifier.issued 3 en
dc.identifier.startpage 402 en
dc.identifier.endpage 404 en
dc.identifier.issn 0332-3102
dc.identifier.uri http://hdl.handle.net/10468/465
dc.description.abstract Warfarin, the standard oral anticoagulant drug used in Ireland, is a widely prescribed medication, particularly in the elderly. A HSE Mid-Western Area wide audit was undertaken over a 12-month period to examine the prevalence and indications for warfarin use and haemorrhagic complications associated with the drug. Every patient receiving warfarin therapy over a 13-week period was included (2564). The age standardised rate varied from 0.09% of 35-39 year olds to 6.1% of 80-84 year olds. Atrial fibrillation was the most common indication (54%) in patients attending the Mid-Western Regional Hospital anticoagulation clinic. The annual cumulative incidence of adverse haemorrhagic events in patients with a recorded INR > or = 5.0 episode was 16.6%. The incidence of major and minor haemorrhagic events per INR > or = 5.0 episode was 1.3% and 15.3% respectively. The most common sites of haemorrhage were genitourinary (39%) and gastrointestinal (27%). No fatal or intracranial haemorrhage relating to episodes of over-anticoagulation were reported during the audit period. The most frequent reason for over-anticoagulation was drug interaction (43%). In 74% of patients, the elevated INR was reversed by omitting or reducing warfarin dose. In 17% of cases, vitamin K was administered. Only 3% of incidents were treated with fresh frozen plasma or prothrombin complex concentrates.Warfarin, the standard oral anticoagulant drug used in Ireland, is a widely prescribed medication, particularly in the elderly. A HSE Mid-Western Area wide audit was undertaken over a 12-month period to examine the prevalence and indications for warfarin use and haemorrhagic complications associated with the drug. Every patient receiving warfarin therapy over a 13-week period was included (2564). The age standardised rate varied from 0.09% of 35-39 year olds to 6.1% of 80-84 year olds. Atrial fibrillation was the most common indication (54%) in patients attending the Mid-Western Regional Hospital anticoagulation clinic. The annual cumulative incidence of adverse haemorrhagic events in patients with a recorded INR > or = 5.0 episode was 16.6%. The incidence of major and minor haemorrhagic events per INR > or = 5.0 episode was 1.3% and 15.3% respectively. The most common sites of haemorrhage were genitourinary (39%) and gastrointestinal (27%). No fatal or intracranial haemorrhage relating to episodes of over-anticoagulation were reported during the audit period. The most frequent reason for over-anticoagulation was drug interaction (43%). In 74% of patients, the elevated INR was reversed by omitting or reducing warfarin dose. In 17% of cases, vitamin K was administered. Only 3% of incidents were treated with fresh frozen plasma or prothrombin complex concentrates. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Irish Medical Organization en
dc.relation.uri http://www.imj.ie//IMJPage_0_1.aspx?issueid=311#Original%20Papers
dc.rights © Irish Medical Journal 2007 en
dc.subject Warfarin en
dc.subject.lcsh Hemorrhage en
dc.subject.lcsh Anticoagulants (Medicine) en
dc.title Warfarin prevalence, indications for use and haemorrhagic events en
dc.type Article (peer-reviewed) en
dc.internal.authorurl http://publish.ucc.ie/researchprofiles/C006/maryrcahill en
dc.internal.authorcontactother Mary Cahill, Pathology, University College Cork, Cork, Ireland. +353-21-490-3000 Email: maryr.cahill@hse.ie en
dc.internal.availability Full text available en
dc.date.updated 2011-11-28T16:38:26Z
dc.description.version Published Version en
dc.internal.rssid 112629780
dc.description.status Peer reviewed en
dc.identifier.journaltitle Irish Medical Journal en
dc.internal.copyrightchecked Yes - Permission granted by editor IMO en
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress martina.hayes@ucc.ie en


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