ABSTRACT
Background: This study aimed to examine the in-hospital and post-discharge mortality rates in patients followed up for warfarin overdose in the cardiology clinic and the factors affecting the mortality.Methods: This study included patients receiving warfarin treatment for atrial fibrillation (AF) and prosthetic heart valve and those hospitalized when warfarin overdose. Furthermore, 48 patients with and without hemorrhagic complications were detected. The causes and rates of mortality of the patients during hospitalization and post discharge were monitored during a mean follow-up of three years.Results: The mean age of 48 patients (32 [66.17%] women) hospitalized for warfarin overdose was 77±10 years. The mean hospitalization period of the patients was 5±4 days, 2±1 day in 11 patients without hemorrhage (22.9%), and 6±3 days in 37 patients with hemorrhage (77.1%). Moreover, 38 patients were receiving warfarin for AF (79.2%) and 10 patients for prosthetic heart valve (20.8%). The mean INR value before hospitalization in patients hospitalized for warfarin was 6.67±2.4, hemoglobin was 10.6±2.3, hematocrit was 33.1±7.5, platelet count was 225±64, and creatinine was 0.9±0.3. In the statistical analysis of 11 patients (22.9%) without hemorrhage and 37 patients (77.1%) hospitalized because of hemorrhage who were being followed up for warfarin overdose, hemoglobin, hematocrit, and platelet count and INR level were considerably low and high in patients with hemorrhage, respectively (Table 2). Figure 1 shows the causes of hemorrhage detected in the patients. On mortality examination, five patients (10.4%) were found to be dead.Conclusions: Being unable to obtain the target INR level or warfarin overdose may lead to serious problem in patients using oral anticoagulants. Whether hemorrhage is observed in patients hospitalized because of warfarin overdose, close monitoring of the patient’s clinical and laboratory parameters is absolutely necessary.