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Báo cáo y học: " Warfarin and fibrinolysis - a challenging combination: an observational cohort study"

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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Warfarin and fibrinolysis - a challenging combination: an observational cohort study | Saarinen et al. Scandinavian Journal of Trauma Resuscitation and Emergency Medicine 2011 19 21 http www.sjtrem.eom content 19 1 21 SCANDINAVIAN JOURNAL OF Et emergency medicine ORIGINAL RESEARCH Open Access Warfarin and fibrinolysis - a challenging combination an observational cohort study Ci Ct . 1 h k 1 1 Di I I IA 1 1 D -l 1 h I I I -r í 2 I_I ir I III iril 3t k rlzlzi I w I 11 r 1 t Sini Saarinen jyrKi ruolaKKa James Boyd lanen vayrynen Harri Luurila and MarKKu Kuisma Abstract Background Patients presenting with ST-segment elevation myocardial infarction STEMI frequently use warfarin. Fibrinolytic agents and warfarin both increase bleeding risK but only a few studies have been published concerning the bleeding risK of warfarin-prescribed patients receiving fibrinolysis. The objective of this study was to define the prevalence for intracranial haemorrhage ICH or major bleeding in patients on warfarin treatment receiving pre-hospital fibrinolysis. Methods This was an observational cohort study. Data for this retrospective case series were collected in HelsinKi Emergency Medical Service catchment area from 1.1.1997 to 30.6.2010. All warfarin patients with suspected ST-segment elevation myocardial infarction STEMI who received pre-hospital fibrinolysis were included. Bleeding complications were detected from Medical Records and classified as ICH major or minor bleeding. Results Thirty-six warfarin patients received fibrinolysis during the study period. Fourteen patients had bleeding complications. One 3 95 CI 0-15 patient had ICH six 17 95 CI 7-32 had major and seven 19 95 CI 9-35 had minor bleeding. The only fatal bleeding occurred in a patient with ICH. Patients age fibrinolytic agent used or aspirin use did not predispose to bleeding complications. High International Normalized Ratio INR seemed to predispose to bleedings with values over 3 but no statistically significant difference was found. Conclusions Bleedings occur frequently in warfarin patients treated .

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