ArticleScandinavian journal of primary health care2007
Bleeding complications during warfarin treatment in primary healthcare centres compared with anticoagulation clinics.
Article in Scandinavian journal of primary health care, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 4 of them syntheses that pooled it.
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Who cites it
16 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Comparison of 4-factor fixed-dose versus 4-factor weight-based-dose prothrombin complex concentrate for emergent warfarin reversal: a systematic review and meta-analysis.Clinical and experimental emergency medicine · 2025Pooled it
- American Society of Hematology 2018 guidelines for management of venous thromboembolism: optimal management of anticoagulation therapy.Blood advances · 2018Guideline
- Guideline
- Association between CHADS₂risk factors and anticoagulation-related bleeding: a systematic literature review.Mayo Clinic proceedings · 2011Pooled it
- Effectiveness of a Nursing Intervention Module on Adherence, Knowledge, Quality of Life, and Complications Among Patients Receiving Anticoagulation therapy-a Randomized Controlled Trial Protocol.Patient preference and adherence · 2022Article
- Outcomes of warfarin therapy managed by pharmacists via hospital anticoagulation clinic versus online anticoagulation clinic.International journal of clinical pharmacy · 2018Observational
- Gastrointestinal bleeding and intracranial hemorrhage in concomitant users of warfarin and antihyperlipidemics.International journal of cardiology · 2017Article
- Impact of regular physical activity on weekly warfarin dose requirement.Journal of thrombosis and thrombolysis · 2016Observational
- The state of point-of-care testing: a European perspective.Upsala journal of medical sciences · 2015Review
- Characterization of patients with atrial fibrillation not treated with oral anticoagulants.Scandinavian journal of primary health care · 2014Article
- Comparison of prothrombin time (INR) results and main characteristics of patients on warfarin treatment in primary health care centers and anticoagulation clinics.BMC health services research · 2013Article
- Factor VII R353Q genetic polymorphism is associated with altered warfarin sensitivity among CYP2C9 *1/*1 carriers.European journal of clinical pharmacology · 2012Article
- Who receives anticoagulant treatment with warfarin and why? A population-based study in Finland.Scandinavian journal of primary health care · 2010Article
- Warfarin sensitivity genotyping: a review of the literature and summary of patient experience.Mayo Clinic proceedings · 2009Review
- Ten-year experience with acenocoumarol treatment in an ambulatory cohort of Spanish patients.Journal of thrombosis and thrombolysis · 2009Article
- Incidence and risk factors for thromboembolism and major bleeding in patients with mechanical heart valves: a tertiary hospital-based study in Botswana.Cardiovascular journal of AfricaArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo examine determinants of bleeding complications during warfarin treatment in an unselected patient population and evaluate possible differences in safety between specialized anticoagulation clinics and primary healthcare centres.
designProspective cohort study. Data were collected with an admission form and medical records were scrutinized in order to pursue all adverse events. Differences between groups were estimated with a t-test and chi-squared test, and univariate and multivariate Cox regression analysis.
settingAll patients treated and monitored with oral anticoagulation in primary healthcare centres and specialized anticoagulation clinics in the Sundsvall and Skellefteå region (northern Sweden) during a five-year period. SUBJECTS: A total of 2731 patients corresponding to 5044 treatment years.
main outcome measuresBleedings were classified as fatal or major. Major bleedings were defined as an event causing admission, prolonged in-hospital care or death.
resultsIn total 195 major bleedings occurred corresponding to 3.9% per treatment year, including 34 fatal events (0.67% per treatment year). Patients monitored at the two specialized anticoagulation clinics combined had a major bleeding frequency of 4.1% as compared with 3.9% at primary healthcare units. The frequency of fatal haemorrhage was 0.57% and 0.76%, respectively. The rate of major and fatal bleeding was age related with an increase of 4% and 5%, respectively, per year.
conclusionsThere was no difference in bleeding complications between patients monitored at primary healthcare centres and specialized anticoagulation clinics. Age was continuously and independently associated with bleeding risk. These study data indicate the need to exercise caution in treatment of the elderly.
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