Predictors of warfarin-induced bleeding in a South Indian cardiology unit

Warfarin-induced bleedingresults in increased morbidity and mortality and higher cost of healthcare. The objective of the study is to identify the predictors of warfarin-induced bleeding in the Cardiology Unit of a teaching hospital.

A cross-sectional study was carried out for a period of six months in a tertiary care teaching hospital. A total of 235 patients were enrolled in the study, to identify the predictors of warfarin-induced bleeding. Only prescriptions with warfarin were selected for the study. The chi square test was used to find the association between demography and risk factors.

Out of 235 patients, 61 (25.95%) had developed warfarin-induced bleeding and the majority were in the age group of 41 - 61 years (60.65%), and it was also found to be higher in women (62.29%). The length of stay was > 14 days (65.57%) and the number of drugs prescribed was in the range of 6 - 12 (52.45%). Aspirin (40.98%), Heparin (36.06%), Clopidogrel (22.95%), and Streptokinase (14.75%) were the most common drugs involved, and other comorbid conditions like diabetes (37.70%), hypertension (32.78%), smoking (57.37%), and alcohol (32.78%) were found to be major predictors of warfarin-induced bleeding in this study. The severity of warfarin-induced most of the bleeding reactions were moderate (44.26%) and the most common site of bleeding was gastrointestinal system (34.42%).

Predictors of warfarin-induced bleeding were found to be female gender, length of stay, number of medications, drugs like aspirin, heparin, and clopidogrel, and other comorbidities like smoking, alcohol, and hypertension.