Yeni nesil oral antikoagülanlar ile warfarin kullanan hastaların kanama komplikasyonu açısından karşılaştırılması: Beş yıllık inceleme

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Tezin Türü: Tıpta Uzmanlık

Tezin Yürütüldüğü Kurum: Sağlık Bilimleri Üniversitesi, İSTANBUL HASEKİ SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, Türkiye

Tezin Onay Tarihi: 2021

Tezin Dili: Türkçe

Öğrenci: YUNUS DOĞAN

Danışman: Özgür SÖĞÜT

Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu

Özet:

Aim The aim of this retrospective study to analyze bleeding complications in patients admitted to the emergency department using oral anticoagulants and compare the rates of major or minor bleeding complications between NOAC and warfarin. Materials and Methods Among a total of 24,774 patients were examined who admitted to the emergency department between 01.01.2015 and 31.12.2019 with a diagnosis of non-traumatic bleeding. A total of 453 patients were included in the study who developed bleeding complications: 99 patients used NOAC and 354 patients used warfarin. Patients with major or minor bleeding due to NOAC and warfarin use were compared in terms of age, gender, comorbid diseases, bleeding type, and clinical outcome. Results In our study, we found 453 patients who developed bleeding complications: 354 patients used warfarin and 99 patients used NOAC. When the frequency of minor bleeding complications and gender were examined, there was no statistically significant difference between the groups using warfarin or NOAC. On the other hand, the mean age was found to be significantly higher in patients who developed minor bleeding due to NOAC use compared to patients who developed minor bleeding due to warfarin use. When the frequency of major bleeding complications and gender were examined, there was no statistically significant difference between the groups using warfarin or NOAC. On the other hand, the mean age was found to be significantly higher in patients who developed major bleeding due to NOAC use compared to patients who developed minor bleeding due to warfarin use. vii While there was no significant difference between patients using warfarin or NOAC in terms of major and fatal intracranial bleeding complication rates, relatively nonfatal gastrointestinal bleeding was observed to be significantly increased in the NOAC group compared to the warfarin group. Conclusion According to our data, although it has some differences all major and all minor bleeding complications in patients using NOAC have a similar bleeding rate compared to patients using warfarin. While warfarin has less risk than NOACs in terms of major and relatively non-fatal gastrointestinal bleeding, it can be said that it has a similar risk in terms of major and fatal intracranial bleeding. Keywords Bleeding complication, warfarin, NOAC