Aug 7, 2007

Death and disability from warfarin-associated intracranial and extracranial hemorrhages

The American Journal of Medicine
Margaret C FangDaniel E Singer

Abstract

Little is known about the outcomes of patients who have hemorrhagic complications while receiving warfarin therapy. We examined the rates of death and disability resulting from warfarin-associated intracranial and extracranial hemorrhages in a large cohort of patients with atrial fibrillation. We assembled a cohort of 13,559 adults with nonvalvular atrial fibrillation and identified patients hospitalized for warfarin-associated intracranial and major extracranial hemorrhage. Data on functional disability at discharge and 30-day mortality were obtained from a review of medical charts and state death certificates. The relative odds of 30-day mortality by hemorrhage type were calculated using multivariable logistic regression. We identified 72 intracranial and 98 major extracranial hemorrhages occurring in more than 15,300 person-years of warfarin exposure. At hospital discharge, 76% of patients with intracranial hemorrhage had severe disability or died, compared with only 3% of those with major extracranial hemorrhage. Of the 40 deaths from warfarin-associated hemorrhage that occurred within 30 days, 35 (88%) were from intracranial hemorrhage. Compared with extracranial hemorrhages, intracranial events were strongly associated wi...Continue Reading

Mentioned in this Paper

Ischemic Cerebrovascular Accident
Subdural Space
Negative Regulation of Coagulation
Incidence Studies
Logistic Regression
Hospital Mortality
Warfarin
Etiology
Decreased Coagulation Activity [PE]
Atrial Fibrillation

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