항응고제와 항혈소판제 복용 환자에서의 비출혈
Epistaxis in Patients Taking Oral Anticoagulant and Antiplatelet Medication
0
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background and Objectives Epistaxis can be caused or exacerbated by anticoagulant and antiplatelet medication. The use of these medications has been increasing markedly in Korea over the recent years due to it becoming an aging society. This retrospective study assessed the proportion of patients taking anticoagulant and antiplatelet in epistaxis patients and monitored differences in patients’ clinical courses. Subjects and Method A retrospective chart review was performed for consecutive patients referred to the ENT department with epistaxis from the emergency room over a one-year period. Results One hundred eighty eight patients presented to the emergency room with epistaxis, representing 0.6% of all emergency attendances. Of these patients, 143 (76%) were referred to the ENT department: of these referred to us, 24% had been taking anticoagulant or antiplatelet medication. There were 5 taking Warfarin, 32 Aspirin, 3 Clopidogrel, and six more than one medication simultaneously. Patients that were taking these medications were older and had higher prevalent rate of hypertension. There was no difference in the bleeding site, the recurrence rate, hospitalization and duration of in-patient stay, and method of treatment between groups. Conclusion Patients with epistaxis in ENT emergency taking anticoagulant and antiplatelet medication have been increasing recently, so an understanding of the action of such medication may enable health care personnels to provide more effective management of these patients.
Abstract
Background and Objectives Epistaxis can be caused or exacerbated by anticoagulant and antiplatelet medication. The use of these medications has been increasing markedly in Korea over the recent years due to it becoming an aging society. This retrospective study assessed the proportion of patients taking anticoagulant and antiplatelet in epistaxis patients and monitored differences in patients’ clinical courses. Subjects and Method A retrospective chart review was performed for consecutive patients referred to the ENT department with epistaxis from the emergency room over a one-year period. Results One hundred eighty eight patients presented to the emergency room with epistaxis, representing 0.6% of all emergency attendances. Of these patients, 143 (76%) were referred to the ENT department: of these referred to us, 24% had been taking anticoagulant or antiplatelet medication. There were 5 taking Warfarin, 32 Aspirin, 3 Clopidogrel, and six more than one medication simultaneously. Patients that were taking these medications were older and had higher prevalent rate of hypertension. There was no difference in the bleeding site, the recurrence rate, hospitalization and duration of in-patient stay, and method of treatment between groups. Conclusion Patients with epistaxis in ENT emergency taking anticoagulant and antiplatelet medication have been increasing recently, so an understanding of the action of such medication may enable health care personnels to provide more effective management of these patients.
참고문헌 (11)
- Elahi MM, "Therapeutic embolization in the treatment of intractable epistaxis", Arch Otolaryngol Head Neck Surg, 121(1), pp.65~69 (1995)
- Pope LE, "Epistaxis: an update on current management", Postgrad Med J, 81(955), pp.309~314 (2005)
- Vedovati MC, "Combined oral anticoagulants and antiplatelets: benefits and risks", Intern Emerg Med, 5(4), pp.281~290 (2010)
- Smith J, "Epistaxis in patients taking oral anticoagulant and antiplatelet medication: prospective cohort study", J Laryngol Otol, 125(1), pp.38~42 (2011)
- Kim SW, "Clinical analysis of epistaxis: result of the recent 10 years", Korean J Otolaryngol-Head Neck Surg, 43(11), pp.1216~1221 (2000)
- Denholm SW, "Warfarin and epistaxis--a case controlled study", J Laryngol Otol, 107(3), pp.195~196 (1993)
- Rainsbury JW, "Clopidogrel versus low-dose aspirin as risk factors for epistaxis", Clin Otololaryngol, 34(3), pp.232~235 (2009)
- Patrono C, "Platelet-active drugs: the relationships among dose, effectiveness, and side effects: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy", Chest, 126(3 Suppl), pp.234S~264S (2004)
- Tay HL, "Aspirin, nonsteroidal anti-inflammatory drugs, and epistaxis. A regional record linkage case control study", Ann Otol Rhinol Laryngol, 107(8), pp.671~674 (1998)
- Hylek EM, "Major he-morrhage and tolerability of warfarin in the first year of therapy a-mong elderly patients with atrial fibrillation", Circulation, 115(21), pp.2689~2696 (2007)
- Soyka MB, "Is severe epistaxis associated with acetylsalicylic acid intake?", Laryngoscope, 120(1), pp.200~207 (2010)