People Aged Over 75 in Atrial Fibrillation on Warfarin: The Rate of Major Hemorrhage and Stroke in More Than 500 Patient-Years of Follow-Up

Objectives: To determine the incidence of major hemorrhage and stroke in people aged 76 and older with atrial fibrillation on adjusted‐dose warfarin who had been recently been admitted to hospital. Design: A retrospective observational cohort study. Setting: A major healthcare network involving four...

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Bibliographic Details
Published in:Journal of the American Geriatrics Society (JAGS) Vol. 53; no. 4; pp. 655 - 659
Main Authors: Johnson, Christina E., Lim, Wen K., Workman, Barbara S.
Format: Journal Article Conference Proceeding
Language:English
Published: Oxford, UK Blackwell Science Inc 01.04.2005
Blackwell
Wiley Subscription Services, Inc
Subjects:
Aged
Aged, 80 and over
Anticoagulants - therapeutic use
Atrial fibrillation
Atrial Fibrillation - complications
Atrial Fibrillation - drug therapy
Biological and medical sciences
Bleeding
Cardiac arrhythmia
Cardiac dysrhythmias
Cardiology. Vascular system
Cohort analysis
Elderly people
Female
Followup studies
Frail
Frail Elderly
General aspects
Haemorrhage
Health care
Health services
Heart
Hemorrhage
Hemorrhage - epidemiology
Hospitals
Humans
Life threatening
Male
Medical records
Medical sciences
Neurology
Older people
Patient admissions
Patients
Pharmaceuticals
Physicians
Practitioner patient relationship
Retrospective Studies
Risk factors
Side effects
Stroke
Stroke - epidemiology
Strokes
Treatment
Vascular diseases and vascular malformations of the nervous system
Victoria - epidemiology
Warfarin
Warfarin - therapeutic use
Victoria
Human
Nervous system diseases
Stroke
Warfarin
Arrhythmia
Coumarine derivatives
Atrial fibrillation
Rate
aged
Cardiovascular disease
Patient
Anticoagulant
Hemorrhage
Excitability disorder
Cerebral disorder
Vascular disease
Antivitamin K
Gerontology
Follow up study
Heart disease
Central nervous system disease
Elderly
Cerebrovascular disease
Geriatrics
ISSN:0002-8614, 1532-5415
Online Access:Get full text
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Summary:Objectives: To determine the incidence of major hemorrhage and stroke in people aged 76 and older with atrial fibrillation on adjusted‐dose warfarin who had been recently been admitted to hospital. Design: A retrospective observational cohort study. Setting: A major healthcare network involving four tertiary hospitals. Participants: Two hundred thirty‐five patients aged 76 and older admitted to a major healthcare network between July 1, 2001, and June 30, 2002, with atrial fibrillation on warfarin were enrolled. Measurements: Information regarding major bleeding episodes, strokes, and warfarin use was obtained from patients, relatives, primary physicians, and medical records. Results: Two hundred twenty‐eight patients (42% men) with a mean age of 81.1 (range 76–94) were included in the analysis. Total follow‐up on warfarin was 530 years (mean 28 months). There were 53 major hemorrhages, for an annual rate of 10.0%, including 24 (45.3%) life‐threatening and five (9.4%) fatal bleeds. The annual stroke rate after initiation of warfarin was 2.6%. Conclusion: The rate of major hemorrhage was high in this old, frail group, but excluding fatalities, resulted in no long‐term sequelae, and the stroke rate on warfarin was low, demonstrating how effective warfarin treatment is.
Bibliography:istex:AA0457220F57E709B2ECCF937D9EABBBA7AA0C57
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ArticleID:JGS53215
This research was presented to the Australian Society of Geriatric Medicine Annual Scientific Meeting in Fremantle, Australia, April 2004, and won the prize for the Bristol‐Myers Squibb Career Investigator Award in Geriatric Medicine for the best presentation of a scientific paper.
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ISSN:0002-8614
1532-5415
DOI:10.1111/j.1532-5415.2005.53215.x