[Hemorrhagic complications of antivitamin K. Report of 75 hospitalized patients].
Hemorrhagic complications are the most frequent complications of antivitamin K (AVK) treatments and can be life-threatening. We report 75 patients from a University Hospital. They were 40 males and 35 females (median age 74 years, 20-94), and were classified into 3 grades according to clinical picture: grade 1 (no surgery or transfusion, grade 2: surgery or blood transfusion needed, grade 3: death). 43 patients had grade 1 complications, 27 grade 2, and 5 grade 3 complications. The most frequent complications were muscular hematomas (36 patients), sub-cutaneous hematomas (14 patients), digestive bleeding (13 patients), hematuria (12 subjects). Eight patients had intracerebral bleeding, of whom 3 died. The treatment time was very variable (1 to 988 weeks). Only half patients had a prothrombin rate (PR) below 20% but two thirds had an INR above 5. This study showed that PR was a poor predictor of hemorrhagic complications. INR was a better parameter. For 15 patients, we considered that the indication was unadapted or questionable, among whom 2 died. This work suggests that the promotion of AVK prescription rules should go on.
Constans
J
J
Service de Médecine Interne et Pathologie Vasculaire, Hôpital Saint-André, Bordeaux.
Sampoux
F
F
Jarnier
P
P
Le Métayer
P
P
Midy
D
D
Morlat
P
P
Bakhach
S
S
Longy-Boursier
M
M
Le Bras
M
M
Beylot
J
J
Baste
J C
JC
Conri
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced*; D006760:Hospitalization; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011517:Prothrombin Time; D012189:Retrospective Studies; D014812:Vitamin K / Q000037:antagonists & inhibitors*
D014812:Vitamin K