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Management of anticoagulant/antiplatelet induced coagulopathy

Harsha Makwana, Ronak Joshi, Sanjay Solanki.

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Now a days use of anticoagulant for various condition such as atrial fibrillation, ischemic heart disease and ischemic stroke has increased to prevent further disease related complication leading to increased frequency for anticoagulant induced coagulopathy. Intracranial hemorrhage is most lethal complication with mortality rate around 60%. The characteristic and management of patient who suffer life threatening bleeding complication related anticoagulant are relatively unreported. To address some of these issue, we have studied such 22 patients for demographic data, coagulation profile, outcome, requirement of blood and blood products.
Material and method:
Patient who were taking anticoagulant and developed coagulopathy were included in our study. Patients excluded were transfusion related coagulopathy, congenital coagulopathy and patient who were not willing for study. Data in form of age, sex, clinical presentation related to coagulopathy, diagnosis, comorbid condition, initial coagulation profile (PT, INR, APTT, Platelet count) and related management coagulation profile after treatment and outcome were collected from patient, relative, and case papers. Data was entered in MS Excel and analysed.
In our 22 patients, 13 were male and 9 were female with maximum no from 41-60 years of age group. They were presented with limb weakness, hematuria and altered sensorium. The main anticoagulants was warfarin followed by aspirin and others. In treatment withdrawal of drug done in all and vitamin K was given in 13 patients.16 patients were discharged while 2 patients expired. Hospital stay was 3 weeks.
Warfarin is the main anticoagulant causing coagulopathy in our study. ICH is a serious complication with high case-fatality rate.Given the increasing use of anticoagulants mainly for cardiovascular problems, the relative benefits and risks of this therapy must be weighed carefully and monitored frequently.

Key words: Anticoagulant, Antiplatelet, Coagulopathy, Intracranial hemorrhage, Hematuria, Warfarin, Vitamin K

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