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

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 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 to . 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 .