Unidad de Investigación en Bibliometría, Universidad San Ignacio de Loyola, Lima, Peru.
Servicio de Neumología, Hospital Nacional Dos de Mayo, Lima, Peru.
Int J Clin Pract. 2021 Dec;75(12):e15001. doi: 10.1111/ijcp.15001. Epub 2021 Nov 22.
Warfarin-induced skin necrosis (WSN) is a rare (0.0.1%-0.1%) and severe adverse reaction. The clinical characteristics of this reaction and its mortality rate have not been explored in a large population. Therefore, we present the case of a Peruvian patient who developed WSN and perform a systematic review of case reports of WSN.
A systematic search was performed using the Pubmed/Medline, Scopus, Web of Science and Embase databases. Patient clinical data were collected and extracted from every case report. Furthermore, we analysed the factors associated with mortality because of WSN using the Poisson regression model with robust variations, obtaining risk ratios (RR) and their respective confidence intervals (95% CI).
We identified 90 case reports that included a total of 111 patients with WSN (mean age 52.5 years), 20.72% of whom died of complications because of WSN. Being male (RR: 2.87; 95% CI 1.21-6.83) and having three or more affected regions (RR: 6.81; 95% CI 2.62-17.74) were associated with an increased risk of death caused by WSN.
This systematic review identified 90 case reports of WSN with three or more affected body regions. Male sex was associated with an increased risk of death. Further studies are needed to analyse and confirm these results.
华法林诱导皮肤坏死（WSN）是一种罕见的（0.0.1%-0.1%）且严重的不良反应。尚未在大人群中探索这种反应的临床特征及其死亡率。因此，我们报告了一名秘鲁患者发生 WSN 的病例，并对 WSN 的病例报告进行了系统回顾。
使用 Pubmed/Medline、Scopus、Web of Science 和 Embase 数据库进行系统搜索。从每篇病例报告中收集并提取患者的临床数据。此外，我们使用具有稳健变化的泊松回归模型分析了与 WSN 死亡率相关的因素，得出风险比（RR）及其各自的置信区间（95%CI）。
我们确定了 90 篇病例报告，其中包括总共 111 名患有 WSN 的患者（平均年龄 52.5 岁），其中 20.72%的患者因 WSN 的并发症而死亡。男性（RR：2.87；95%CI 1.21-6.83）和有三个或更多受累区域（RR：6.81；95%CI 2.62-17.74）与 WSN 导致的死亡风险增加相关。
本系统评价确定了 90 篇有三个或更多受累身体区域的 WSN 病例报告。男性与死亡风险增加相关。需要进一步的研究来分析和确认这些结果。
