Assessment of complications of anticoagulant therapy at medical wards of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
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Date
2014-01
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Addis Ababa University
Abstract
Anticoagulant therapy is one of the most common form of medical treatment. The most common
anticoagulant therapy complications are bleeding and thromboembolic complications. Bleeding is
the primary complication. Factors that can affect the complications include age, gender,
comorbidities, intensity of anticoagulant effect, length of therapy and concomitant drugs. The
objective of the study was to assess complications of anticoagulant therapy at medical wards of
Tikur Anbessa Specialized Hospital. A prospective longitudinal study design involving patient
follow-up and chart review was conducted from November to June 2014. Chi-square test and
Linear Mixed Model regression were employed to examine the relationships and associations
between variables. The incidence of complications of anticoagulant therapy was found to be 60
(26%). Bleeding was the most common reported 27 (12.4%) (5.2% major, 10.7% minor), followed
by thromboembolism 12 (7.1%), bruising 10 (5.9%), heparin induced thrombocytopenia 9 (5.3%)
and skin necrosis 8 (4.7%). Sex, concomitant drugs, intensity of INR/aPTT values, usual trend of
coagulation treatment and having coagulation profiles from different laboratory sites had been
associated with complications. However, age, comorbidities, length of therapy, number of
anticoagulants and anticoagulant therapy related factors were not significant risk factors. The
findings of this study indicated that patient on anticoagulant therapy at medical wards were at higher
risk of bleeding followed by thromboembolic complications. Availability of coagulation laboratory
reagents at Tikur Anbessa Specialized Hospital and preparing guidelines on anticoagulant therapy
harmonized with the laboratory values is recommended.
Key words: Complication, bleeding, thromboembolism, skin necrosis, bruising, HIT, INR,
aPTT, anticoagulants
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Keywords
Complication; Bleeding; Thromboembolism; Skin necrosis, bruising, HIT, INR, aPTT, anticoagulants