PURPOSE: To evaluate the frequency, severity and preventability of warfarin-induced cerebral haemorrhages due to warfarin and warfarin-drug interactions in patients living in the county of Ostergötland, Sweden. METHODS: All patients with a diagnosed cerebral haemorrhage at three hospitals during the period 2000-2002 were identified. Medical records were studied retrospectively to evaluate whether warfarin and warfarin-drug interactions could have caused the cerebral haemorrhage. The proportion of possibly avoidable cases due to drug interactions was estimated. RESULTS: Among 593 patients with cerebral haemorrhage, 59 (10%) were assessed as related to warfarin treatment. This imply an incidence of 1.7/100,000 treatment years. Of the 59 cases, 26 (44%) had a fatal outcome, compared to 136 (25%) among the non-warfarin patients (p < 0.01). A warfarin-drug interaction could have contributed to the haemorrhage in 24 (41%) of the warfarin patients and in 7 of these (12%) the bleeding complication was considered being possible to avoid. CONCLUSIONS: Warfarin-induced cerebral haemorrhages are a major clinical problem with a high fatality rate. Almost half of the cases was related to a warfarin-drug interaction. A significant proportion of warfarin-related cerebral haemorrhages might have been prevented if greater caution had been taken when prescribing drugs known to interact with warfarin. (c) 2007 John Wiley & Sons, Ltd.
PURPOSE: To evaluate the frequency, severity and preventability of warfarin-induced cerebral haemorrhages due to warfarin and warfarin-drug interactions in patients living in the county of Ostergötland, Sweden. METHODS: All patients with a diagnosed cerebral haemorrhage at three hospitals during the period 2000-2002 were identified. Medical records were studied retrospectively to evaluate whether warfarin and warfarin-drug interactions could have caused the cerebral haemorrhage. The proportion of possibly avoidable cases due to drug interactions was estimated. RESULTS: Among 593 patients with cerebral haemorrhage, 59 (10%) were assessed as related to warfarin treatment. This imply an incidence of 1.7/100,000 treatment years. Of the 59 cases, 26 (44%) had a fatal outcome, compared to 136 (25%) among the non-warfarinpatients (p < 0.01). A warfarin-drug interaction could have contributed to the haemorrhage in 24 (41%) of the warfarinpatients and in 7 of these (12%) the bleeding complication was considered being possible to avoid. CONCLUSIONS:Warfarin-induced cerebral haemorrhages are a major clinical problem with a high fatality rate. Almost half of the cases was related to a warfarin-drug interaction. A significant proportion of warfarin-related cerebral haemorrhages might have been prevented if greater caution had been taken when prescribing drugs known to interact with warfarin. (c) 2007 John Wiley & Sons, Ltd.
Authors: Henrik Lövborg; Linda Ring Eriksson; Anna K Jönsson; Thomas Bradley; Staffan Hägg Journal: Eur J Clin Pharmacol Date: 2012-02-19 Impact factor: 2.953
Authors: Andreas D Meid; Andreas Groll; Ulrich Schieborr; Jochen Walker; Walter E Haefeli Journal: Eur J Clin Pharmacol Date: 2016-12-24 Impact factor: 2.953
Authors: L Gschwind; V Rollason; C Lovis; F Boehlen; P Bonnabry; P Dayer; J A Desmeules Journal: Eur J Clin Pharmacol Date: 2012-08-19 Impact factor: 2.953
Authors: Maria A P Martins; Daniel D Ribeiro; Vandack A Nobre; Fabiana R Pereira; Cibele C César; Manoel O C Rocha; Antonio L P Ribeiro Journal: Eur J Clin Pharmacol Date: 2012-09-28 Impact factor: 2.953