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Assessment of factors affecting mortality in geriatric patients with warfarin overdose

Seda Dagar1, Emine Emektar1, Hüseyin Uzunosmanoglu1

  • 1Department of Emergency Medicine, Kecioren Training and Research Hospital, Ankara, Turkey.

Turkish Journal of Emergency Medicine
|October 22, 2020
PubMed

Insights

Elderly patients experiencing warfarin overdose face higher mortality risks due to male gender, advanced age, and impaired liver or kidney function. Close monitoring and patient education are crucial for managing warfarin complications in older adults.

Area of Science:

  • Geriatric Medicine
  • Pharmacology
  • Internal Medicine

Background:

  • Warfarin is a common anticoagulant medication used in geriatric patients.
  • Warfarin overdose can lead to serious complications, including bleeding and increased mortality.
  • Identifying risk factors for mortality in elderly patients with warfarin overdose is critical for improving patient outcomes.

Purpose of the Study:

  • To conduct a demographic analysis of complications in geriatric patients with warfarin overdose.
  • To determine the factors influencing in-hospital mortality in this patient population.

Main Methods:

  • Retrospective study including patients aged 65+ with an international normalized ratio (INR) > 3.5 IU.
  • Comparison of characteristics between surviving and non-surviving patients.
  • Multivariate logistic regression analysis to identify predictors of in-hospital mortality.

Main Results:

  • A total of 302 geriatric patients were analyzed, with a bleeding rate of 14.2%.
  • Significant differences were observed in age, gender, chronic renal failure, creatinine, AST, and ALT levels between survivors and non-survivors.
  • Predictors of in-hospital mortality included elevated AST and creatinine, advanced age, and male gender.

Conclusions:

  • Male gender, advanced age, and hepatic/renal dysfunction are significant predictors of in-hospital mortality in elderly patients with warfarin overdose.
  • Recommendations include enhanced patient education on warfarin side effects, frequent INR monitoring, and stricter follow-up schedules for older patients, especially those with renal or hepatic impairment.
Abstract

Keywords:
Ageinganticoagulantgeriatricsmortalitywarfarin

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