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Volume : 25 Issue : 4 Year : 2019

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Prognosis of Stroke Patients Using Warfarin Treatment Over Eighty Years Old: Clinical Observation [Turk J Neurol]
Turk J Neurol. Ahead of Print: TJN-53367

Prognosis of Stroke Patients Using Warfarin Treatment Over Eighty Years Old: Clinical Observation

R. Gokcen Gozubatik-Celik, Hayriye Kucukoglu, Eda Coban, Songul Senadim, Ayhan Koksal
Department of Neurology, Bakirkoy Research and Training Hospital for Neurologic and Psychiatric Diseases

Objective: Warfarin treatment is a partially preferred prophylaxis in patients with advanced ischemic stroke due to possible side effects/drug interactions. In this study, we aimed to investigate the frequency of warfarin use, possible side effects and reasons for discontinuation of treatment in stroke patients over the age of 80 years.
Materials and Methods: 189 of 589 stroke patients were detected retrospectively who are over 80 years of age and were followed up for cardioembolic stroke between 2014-2018. Demographic/clinical/laboratory/radiological information together with the reasons for discontinuation of the drug were noted in excel from their files.
Results: 189 patients (88 women) were included. Average duration of the warfarin usage was noted as 5.02 ± 3.4 years (min 6 months, max 11 years). 94 of them (49.7%) were treated with new oral anticoagulants in the last 2 years due to side effects and/or social reasons, while 90 (47.6%) were on regular follow-up with warfarin. Gastrointestinal bleeding was noted as the most common side effect of drug discontinuation (41.4%), while the most important risk factor in GIS symptoms was antihyperlipidemic-drugs (p = 0.001). Irregular hypertension was the most important risk factor for side effects due to its triggering impact on bleeding (p = 0.000). The average INR level during intense bleeding was calculated as 3.8 ± 1.3. Patients with an INR level of 2.5 or higher, had significantly faced other drug-related side effects (peripheral edema, diarrhea, shortness of breath, headache, dizziness) compared to other INR values (p = 0.003).
Conclusion: Especially in elder stroke patients under antihyperlipidemic treatments, avoiding unnecessary drug use and making sure that the patient reaches required prophylaxis without being dependent on age is crucial.

Keywords: elderly, stroke, warfarin, adverse effects




Corresponding Author: R. Gokcen Gozubatik-Celik, Türkiye


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