Evaluation of the cause of death in the elderly with overdose of warfarin

Abstract

According to previous studies and the fact that men die more than women due to warfarin, but women suffer from light bleeding more than men, due to the lack of a similar study in our region, the purpose of this study was to investigate the cause of warfarin use, duration Drug use and ultimately the cause and location of death in elderly patients with overdose of warfarin.

Methods: This study is a retrospective cross-sectional study over 3 years. All patients aged 65 years or older with a history of warfarin use with INR levels higher than 3.5 IU who referred to ED between April 2018 and April 1, 2021 were included in this study. First, the demographic information of the study population was obtained using software created from the hospital information system. Then, the cause and disease for which warfarin was taken, the duration of use, the site of bleeding to which the patient referred, and finally death were recorded in the emergency department or ward. Patients with incomplete records, under the age of 65, taking other anticoagulants other than warfarin, or those with liver failure were excluded from the study.

Results: In this study, 72 people were hospitalized due to overdose or toxicity of warfarin, 38 of whom met the inclusion criteria. The mean age of patients (73.59-78.88; 95% CI) was 76.24 ± 8.05 years, the mean age was 77.5 years and the mean age of the population was between 68 and 82 years. Of these patients, 19 patients (50%) were male and 19 patients (50%) were female. The most common cause of warfarin use among these patients was valve replacement and pulmonary embolism. The most common complaint of patients at the time of referral was gastrointestinal bleeding and then hematuria. There was a significant relationship between age and indication for warfarin use in patients, which is the mean inverse relationship (Corelation Coefficient = -0.328, Pv = 0.04). In our study, the mean duration of warfarin use in patients was 2.80 ± 4.23 years. The mean INR of patients was 6.04 ± 1.44 units.