title: Problems, interventions and complications in long-term oral anticoagulation therapy.
abstract: BACKGROUND
  If problems, interventions and complications occurring during oral anticoagulation (OAC) are related with age, indication for OAC, hypertension, diabetes, previous stroke, and number of additional drugs.
  
  
  METHODS
  Clinical characteristics, additional drugs, problems, interventions and complications of outpatients whose OAC was controlled between two years were registered. Potential gastrointestinal and urologic bleeding sources were eliminated prior to initiation of OAC. Five-hundred-seventy-nine patients (mean age 65 years, 44% female) were observed for 590 patient-years.
  
  
  RESULTS
  Medical problems occurred in 352/100 patient-years (% p-y), organisational problems in 276% p-y, interventions in 636% p-y and complications in 13.8% p-y. Patients >65 years had less organisational problems (254 vs. 302% p-y, p = 0.0092) and interventions (574 vs. 713% p-y, p = 0.0003) than patients < or =65 years. The 35 patients with heart valve prosthesis had more life-threatening and fatal complications (12% p-y) than the 360 patients with atrial fibrillation (1.0% p-y), 128 patients with venous thromboembolism or 56 patients with other indications (0.0% p-y, p = 0.0024). Problems, interventions and complications were not related with hypertension (n = 297), diabetes (n = 97) or previous stroke (n = 90). Patients with >3 additional drugs/day had a higher complication rate than patients with < or =3 drugs/day (21 vs. 8.7% p-y, p = 0.0238). Patients with complications had more headache (27 vs. 20% p-y, p = 0.0036), chest pain (45 vs. 27% p-y, p = 0.0150), abdominal pain (25 vs. 15% p-y, p = 0.0350) and pain in the limbs (55 vs. 42% p-y, p = 0.0044) than patients without complications.
  
  
  CONCLUSIONS
  By careful monitoring, eliminating potential bleeding sources, treating pain adequately and minimizing additional drugs the complications of OAC can be kept low.
authors.affiliation: 2nd Medical Department, KA Rudolfstiftung, Wien, Austria. claudia.stoellberger@chello.at
authors.forename: Claudia
authors.initials: C
authors.lastname: Stöllberger
authors.forename: Josef
authors.initials: J
authors.lastname: Finsterer
authors.forename: Thomas
authors.initials: T
authors.lastname: Länger
authors.forename: Barbara
authors.initials: B
authors.lastname: Schneider
authors.forename: Cornelius
authors.initials: C
authors.lastname: Wehinger
authors.forename: Pierre
authors.initials: P
authors.lastname: Hopmeier
authors.forename: Jörg
authors.initials: J
authors.lastname: Slany
mesh_terms: D000368:Aged; D000553:Ambulatory Care / Q000379:methods / Q000706:statistics & numerical data; D000704:Analysis of Variance; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced / Q000517:prevention & control; D006801:Humans; D008134:Long-Term Care / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D018709:Statistics, Nonparametric; D013923:Thromboembolism / Q000139:chemically induced / Q000517:prevention & control
chemical_list: D000925:Anticoagulants