ICJEM
Intercontinental Journal of Emergency Medicine

The Intercontinental Journal of Emergency Medicine aims to publish issues related to all fields of emergency medicine and all specialties involved in the management of emergencies in the hospital and prehospital environment of the highest scientific and clinical value at an international level and accepts articles on these topics.

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Original Article
Retrospective analysis of 1-month and 1-year mortality due to bleeding in patients using warfarin
Abstract
Aims: Warfarin is approved for the prevention and/or treatment of venous thrombosis, pulmonary embolism, and thromboembolic complications associated with atrial fibrillation and/or cardiac valve replacement. international normalized ratio (INR) above the therapeutic range increases the risk of bleeding, its level below the therapeutic range increases the risk of thromboembolic complications. We aimed to evaluate the effect of patients' INR levels on one-month and one-year mortality.
Methods: The hospital's electronic information management system retrospectively screened between 01.01.2015, and 31.12.2016. Patients who applied to the emergency department (ED) with a history of warfarin use, were included in the study. The receiver operating characteristics (ROC) analysis and the area under the curve (AUC) for the mortality estimation calculations were used for statistical analysis.
Results: Total of 1299 patients with elevated INR due to warfarin use were included in the study. The major ED admission causes were bleeding (n = 338, 26.02%) and INR control with no other complaint (n = 56, 4.31%). Mortality was observed within one month in 118 (9.1%) patients and within one year in 292 (22.5%) patients. The ROC analysis for 1-month and 1-year mortality estimation, AUC values for age, INR, urea, and creatinine were 0.640, 0.549, 0.702, 0.629 and 0.629, 0.532, 0.671, 0.608, respectively.
Conclusion: The patients admitted to ED due to high INR values are usually corrected their INR values and then discharged. These patients’ one-year mortality is high so to identify and eliminate the underlying cause of the INR elevation is important.

Keywords : Warfarin, emergency department, mortality, international normalized ratio

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Article available in :
Volume 3, Issue 2, 2025
Page : 31-34
https://doi.org/10.51271/ICJEM-0054
Article Information
Received : 26 Feb 2025
Accepted : 15 Mar 2025
Published : 13 Jun 2025
Corresponding Author :

İsmail Erkan Aydın: Department of Emergency Medicine, Alanya Alaaddin Keykubat University, Faculty of Medicine, Antalya, Turkiye

[email protected]
Citation : Aydın İE, Karakuş Yılmaz B, Çevik E. Retrospective analysis of 1-month and 1-year mortality due to bleeding in patients using warfarin. Intercont J Emerg Med. 2025;3(2):31-34.

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