Bussey H I, Rospond R M, Quandt C M, Clark G M
Department of Pharmacology, University of Texas Health Science Center, San Antonio 78284-7765.
Pharmacotherapy. 1989;9(4):214-9. doi: 10.1002/j.1875-9114.1989.tb04128.x.
Whenever long-term anticoagulation is prescribed, the risks of such therapy must be evaluated accurately. Whether these risks are influenced by the duration of therapy, the indication for therapy, patient demographics and social habits, or the use of an anticoagulation clinic is controversial. This study examined the occurrence rates of major hemorrhage, minor hemorrhage, and thromboembolic events among an inception cohort of 82 patients receiving long term-warfarin therapy in an anticoagulation clinic. During 199.34 patient-years of observation, there were 4 major hemorrhages (0.0201/patient-year), 31 minor hemorrhages (0.1555/patient-year), and 7 thromboembolic events (0.0351/patient-year). Although each type of event tended to occur during the first 6 months of therapy, this trend was not statistically significant. Failure to demonstrate statistically significant influence of any of the evaluated variables may have been due to the unusually low rate of complications, a finding that may reflect the safety of anticoagulant therapy when managed by a specialized clinic.
每当开具长期抗凝治疗处方时，必须准确评估该治疗的风险。这些风险是否受治疗持续时间、治疗指征、患者人口统计学特征和社会习惯或抗凝门诊的使用影响，仍存在争议。本研究调查了在一家抗凝门诊接受长期华法林治疗的82例起始队列患者中，大出血、小出血和血栓栓塞事件的发生率。在199.34患者年的观察期内，发生了4例大出血（0.0201/患者年）、31例小出血（0.1555/患者年）和7例血栓栓塞事件（0.0351/患者年）。尽管每种类型的事件都倾向于在治疗的前6个月发生，但这种趋势在统计学上并不显著。未能证明任何评估变量具有统计学上的显著影响，可能是由于并发症发生率异常低，这一发现可能反映了由专业门诊管理抗凝治疗时的安全性。
