Résumé
Objective:To assess the risk of venous thromboembolism (VTE) and anticoagulation-related bleeding of acute critical emergency patients staying in the emergency department at least 72 h, so as to improve the ability of emergency physicians to identify risk factors of VTE and their awareness of safety prevention in these patients.Methods:Multicenter emergency internal medicine patients meeting the inclusion criteria at the same time were collected. Padua and Caprini scores were used to evaluate the risk of VTE and the HAS-BLED score was used to assess the risk of anticoagulation-related bleeding.Results:A total of 930 emergency patients from 7 medical centers were enrolled in our study from January 15, 2021 to March 15, 2021. The proportion of high-risk population with VTE was 50.22% with Padua score and 78.49% with Caprini score, respectively. The proportion of high-risk bleeding (HAS-BLED score) was 40.43%.Conclusions:More than half of the acute critical ill patients who stay in emergency department for more than 72 h are at high risk of VTE. This group of patients have a relatively low risk of anticoagulation-related bleeding.
Résumé
Introduction: Bleeding is a significant complication whenpatients are on anticoagulant therapy. The risk of bleedingoverall when anticoagulant therapy is used is 3.8%. A numberof risk factors are associated with increased bleeding whenpatients are on anticoagulants. A practical risk score HASBLED score was developed to estimate 1year risk for majorbleeding in patients with atrial fibrillation. This study aimedto understand to assess the relevance of HAS-BLED scorein predicting bleeding in patients coming to AJ institute ofmedical sciences.Material and methods: We conducted a case control studyin patients on Warfarin therapy for Atrial fibrillation whopresented with major bleeding manifestations betweenSeptember2017-2018 in a tertiary care centre in AJ InstituteOf Medical Sciences in South India. Patients or their medicalpower of attorneys provided written informed consent. Atotal no of 100 patients were enrolled based on the inclusioncriteria patients aged more than 18 years. They were groupedinto cases who had bleeding and controls who did not havebleeding. HAS BLED score was calculated. The data wasentered in Microsoft Excel and was analysed with SPSSResults: Total of 100patients (50cases and 50controls) werestudied. On analysing the HAS-BLED score the P valueshowed significant difference between the case and controlgroups. The sensitivity was 80% and specificity was 68%. Thepositive and negative predictive value of HAS-BLED valueswere 71.4% and 77.27% respectively.Conclusion: Our study emphasises the need for making betteruse of HAS-BLED score in predicting bleeding and the needfor monitoring the INR regularly and educating patients onWarfarin therapy about frequent monitoring, the risks ofbleeding and to seek early medical attention on developingbleeding.
Résumé
Introduction@#Although we have known for almost last few years that Atrial fibrillation has been increasing by patients in Mongolia. Atrial fibrillation, the most common sustained chronic arrhythmia, with atrial rates of 200-500 beats per minute in patients. Most patients atrial fibrillation have structural heart disease such us mitral stenosis or regurgitation, acute myocardial infarction, Wolff-Parkinson-White syndrome, thyrotoxicosis, recent cardiothoracic surgery, cardiomyopathy, myocarditis or pulmonary disease. Atrial Fibrillation increases the risk of stroke, thromboemboli and mortality of adults with structural heart disease [4]. The symptoms most frequently reported by patients with atrial fibrillation is a rapid, irregullar heartbeat, chest pain, shortness of breath, lightheadedness and dizziness.@*Goal@#For that reason we decided to research patients with atrial fibrillation who are treated by the inpatient cardiology department of General hospital of defense and Law Enforcement between 2010-2014 years.@*Conclusion@#</br> 1. The hospitalized patients are observed only 6 cases of atrial fibrillation in 2010 years, even though the prevalence of atrial fibrillation has been increasing 75 cases in 2014 years, as a result it developed 30% during 4 years in hospitalized patients </br> 2. CHA2DS2-VАSc score was high risk of stroke /62.5% of them /most patients with both paroxysmal and chronic atrial fibrillation should be anticoagulated to reduce the occurrence of thromboemboli </br> 3. HAS-BLЕD score has became highest rick of bleeding /32.7% of all patients. For the reason we should be select correctly drugs for patients an anticoagulation treatment and they are controled INR every month