Pavel Skok (Author), Marija Skok (Author)

Abstract

Izhodišča. V zadnjem obdobju je uporaba antikoagulacijskih zdravil za zdravljenje in preprečevanje trombembolizmov v svetu in pri nas v porastu. Zdravljenje s temi učinkovinami je zahtevno, se zlasti pri starejših s pridruženimi boleznimi, ki uporabljajo različna zdravila. Namen raziskave je bil ugotoviti pogostnost resnih zapletov, klinično pomembnih krvavitev iz zgornje prebavne cevi pri bolnikih, zdravljenih z oralnimi antikoagulacijskimi zdravili v prospektivni kohortni raziskavi. Bolniki in metode. V raziskavo so vključeni vsi bolniki, pri katerih smo v obdobju od 1. januarja 1994 do 31. decembra 2003 opravili nujne endoskopske preiskave zgornje prebavne cevi zaradi krvavitve iz prebavne cevi. Rezultati. Pregledali smo 6416 bolnikov: 2452 žensk (38,2 %) in 3964 moških (61,8 %) povprečne starosti 59,3 leta v razponu od 1-106 let, SD 17,2 leta. Med bolniki so prevladovali starostniki, saj je bilo 53,4 % preiskovancev starejših od 60 let. Pri 86,4 % preiskovancev smo ugotovili vzrok krvavitve v zgornji prebavni cevi. V zadnjem tednu, preden so zakrvaveli, je 20,4 % (1309/6416) preiskovancev uporabljalo nesteroidna protivnetna zdravila, oralna antikoagulacijska zdravila ali salicilate vsaj v enkratnem dnevnem odmerku. Pomemben del bolnikov, 6,3 % (82/1309), z obilno krvavitvijo iz zgornje prebavne cevi, je uporabljal oralna antikoagulacijska zdravila in imel vrednosti INR > 5, del med njimi, 25,6 %, pa celo INR > 10. Umrljivost med bolniki s povišanim INR je bila 17,1 %. Zaključki. Krvavitev iz prebavne cevi je resen zaplet zdravljenja z različnimi zdravili. Varnejša uporaba oralnih antikoagulacijskih zdravil mora še zlasti temeljiti na skrbni izbiri bolnikov in indikacij ter vztrajati pri natančnem uživanju priporočenih odmerkov zdravil.

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Language: Slovenian
Year of publishing:
Typology: 1.01 - Original Scientific Article
Organization: UM - University of Maribor
UDC: 616.34-005
COBISS: 2491199 Link will open in a new window
ISSN: 1318-0347
Parent publication: Zdravniški vestnik
Views: 1040
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Secondary language: English
Secondary title: Adverse effects of anticoagulation treatment: clinically significant upper gastrointestinal hemorrhage
Secondary abstract: Background. Over the last years, the use of oral anticoagulant treatment has increased dramatically, principally for the prevention of venous thrombosis and thrombembolic events. This treatment is demanding, especially among the elderly with concommitant diseases and different medication. Aim of the study to evaluate the rate of serious complications, clinically significant hemorrhage from upper gastointestinal tract in patients treated with oral antiocoagulants in a prospective cohort study. Patients and methods. Included were patients admitted to our institution between January 1, 1994 and December 31, 2003 due to gastrointestinal hemorrhage. Emergency endoscopy and laboratory testing was performed in all patients. Results. 6416 patients were investigated: 2452 women (38.2 %) and 3964 men (61.8 %), mean age 59.1 years, SD 17.2. Among our patients, 55 % were aged over 60 years. In 86.4 % of patients the source of bleeding was confirmed in the upper gastrointestinal tract. In the last week prior to bleeding, 20.4 % (1309/6416) of all patients were regularly taking nonsteroidal anti-inflammatory drugs, anticoagulant therapy or antiplatelet agents in single daily doses at least. 6.3 % of patients (82/1309) with abundant hemorrhage from upper gastrointestinal tract were using oral anticoagulant therapy and had INR > 5 at admission, 25.6 % of them had INR > 10. The mortality of patients using oral anticoagulants and INR > 5 was 17.1 %. Conclusions. Upper gastrointestinal hemorrhage is a serious complication of different medications, particularly in elderly patients. Safe use of anticoagulant therapy is based on careful selection of patients and correct intake of the prescribed drugs.
Secondary keywords: Anticoagulants;adverse effects;Antikoagulanti;Stranski učinki;Drug Therapy;Zdravljenje z zdravili;Upper Gastrointestinal Tract;Zgornja prebavna cev;Hemorrhage;Krvavitev;
URN: URN:NBN:SI
Type (COBISS): Not categorized
Pages: str. II-75 - II-80
Volume: ǂLetn. ǂ75
Issue: ǂsupl. ǂII
Chronology: 2006
ID: 9101918