Warfarin Toxicity Patients in the Emergency Department

ABSTRACT

PURPOSE: The number of patients who take warfarin is growing, and so is the number of complications. However, the treatments of these complications vary widely due to the lack of guidelines. Therefore, we felt the need to establish guidelines for warfarin toxicity treatment. METHODS: We reviewed the medical records of the patients taking warfarin, at the time of Severance Hospital Emergency Center visit with bleeding complications or an initial prothrombin time (PT) in international normalized ratio (INR) of more than 3, from March 1, 1999, to February 28, 2001. These patients were divided into major, minor, and no bleeding groups according to their bleeding status, and the groups were compared analyzed. RESULTS: There were 57 patients who met the criteria. Atrial flutter/fibrillation and heart valve replacement patients made up 71.9%. No significant difference in initial PT (INR) existed between the three bleeding groups. However, the difference existed in the amount of vitamin K given to the three bleeding groups. CONCLUSION: Initial PT (INR) is not an appropriate guide for treatment of bleeding complications of warfarin toxicity. Clinical manifestations were more reliable and significant to treat for bleeding complications of warfarin toxicity.