Yeni nesil oral antikoagülanlar ile warfarin kullanan hastaların kanama komplikasyonu açısından karşılaştırılması: Beş yıllık inceleme
Comparison of new oral anticoagulants and warfarin in patients in terms of bleeding complication: A five-year review
Yazar: YUNUS DOĞAN
Danışman: PROF. DR. ÖZGÜR SÖĞÜT
Sağlık Bilimleri Üniversitesi / İstanbul Haseki Eğitim ve Araştırma Hastanesi / Acil Tıp Ana Bilim Dalı
Derece: Tıpta Uzmanlık, 2021
Konu: Sağlık Eğitimi = Health Education ; İlk ve Acil Yardım = Emergency and First Aid
Dizin: Antikoagülanlar = Anticoagulants ; Hemorajiler = Hemorrhage ; Komplikasyonlar = Complications ; Serebral hemoraji = Cerebral hemorrhage ; Varfarin = Warfarin

Özet:
Aim
The aim of this retrospective study to analyze bleeding complications in patients
admitted to the emergency department using oral anticoagulants and compare the rates
of major or minor bleeding complications between NOAC and warfarin.
Materials and Methods
Among a total of 24,774 patients were examined who admitted to the emergency
department between 01.01.2015 and 31.12.2019 with a diagnosis of non-traumatic
bleeding. A total of 453 patients were included in the study who developed bleeding
complications: 99 patients used NOAC and 354 patients used warfarin. Patients with
major or minor bleeding due to NOAC and warfarin use were compared in terms of
age, gender, comorbid diseases, bleeding type, and clinical outcome.
Results
In our study, we found 453 patients who developed bleeding complications: 354
patients used warfarin and 99 patients used NOAC.
When the frequency of minor bleeding complications and gender were examined, there
was no statistically significant difference between the groups using warfarin or NOAC.
On the other hand, the mean age was found to be significantly higher in patients who
developed minor bleeding due to NOAC use compared to patients who developed
minor bleeding due to warfarin use.
When the frequency of major bleeding complications and gender were examined, there
was no statistically significant difference between the groups using warfarin or NOAC.
On the other hand, the mean age was found to be significantly higher in patients who
developed major bleeding due to NOAC use compared to patients who developed
minor bleeding due to warfarin use.
vii
While there was no significant difference between patients using warfarin or NOAC
in terms of major and fatal intracranial bleeding complication rates, relatively nonfatal gastrointestinal bleeding was observed to be significantly increased in the NOAC
group compared to the warfarin group.
Conclusion
According to our data, although it has some differences all major and all minor
bleeding complications in patients using NOAC have a similar bleeding rate compared
to patients using warfarin. While warfarin has less risk than NOACs in terms of major
and relatively non-fatal gastrointestinal bleeding, it can be said that it has a similar risk
in terms of major and fatal intracranial bleeding.
Keywords
Bleeding complication, warfarin, NOAC

Abstract:
Aim
The aim of this retrospective study to analyze bleeding complications in patients
admitted to the emergency department using oral anticoagulants and compare the rates
of major or minor bleeding complications between NOAC and warfarin.
Materials and Methods
Among a total of 24,774 patients were examined who admitted to the emergency
department between 01.01.2015 and 31.12.2019 with a diagnosis of non-traumatic
bleeding. A total of 453 patients were included in the study who developed bleeding
complications: 99 patients used NOAC and 354 patients used warfarin. Patients with
major or minor bleeding due to NOAC and warfarin use were compared in terms of
age, gender, comorbid diseases, bleeding type, and clinical outcome.
Results
In our study, we found 453 patients who developed bleeding complications: 354
patients used warfarin and 99 patients used NOAC.
When the frequency of minor bleeding complications and gender were examined, there
was no statistically significant difference between the groups using warfarin or NOAC.
On the other hand, the mean age was found to be significantly higher in patients who
developed minor bleeding due to NOAC use compared to patients who developed
minor bleeding due to warfarin use.
When the frequency of major bleeding complications and gender were examined, there
was no statistically significant difference between the groups using warfarin or NOAC.
On the other hand, the mean age was found to be significantly higher in patients who
developed major bleeding due to NOAC use compared to patients who developed
minor bleeding due to warfarin use.
vii
While there was no significant difference between patients using warfarin or NOAC
in terms of major and fatal intracranial bleeding complication rates, relatively nonfatal gastrointestinal bleeding was observed to be significantly increased in the NOAC
group compared to the warfarin group.
Conclusion
According to our data, although it has some differences all major and all minor
bleeding complications in patients using NOAC have a similar bleeding rate compared
to patients using warfarin. While warfarin has less risk than NOACs in terms of major
and relatively non-fatal gastrointestinal bleeding, it can be said that it has a similar risk
in terms of major and fatal intracranial bleeding.
Keywords
Bleeding complication, warfarin, NOAC