老年哈斯出血患者抗凝药物使用评价及出血风险研究

Angela Mariam Reji, Christy Abraham, Nancy Antony, Rupali Kumar, Mrs., Lincy George, K. Krishnakumar
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摘要

抗凝治疗是最传统的治疗干预形式,是治疗和预防各种疾病的基石,包括心房颤动(AF)、急性冠状动脉综合征(ACS)、静脉血栓栓塞(VTE)和接受心脏手术的患者。出血是抗凝剂的主要并发症,即使在其治疗限度内使用。一种创新的HAS-BLED评分工具用于评估抗凝治疗患者的出血风险,支持医生更好地做出临床决策2,3。目的是评估药物使用和出血风险的抗凝血药物在老年患者中使用HAS-BLED评分。一项前瞻性观察研究在一家三级护理医院进行了为期6个月的100名患者。其中男性占61%,女性占49%。大多数患者年龄在65 ~ 70岁(53%),71 ~ 75岁(31%),最小小于75岁(16%)。最常见的处方剂型是静脉注射(79%),药物是肝素(52%)。采用HAS- BLED评分法对20例服用华法林患者的出血风险进行评估,风险类别大于等于3级(60%)高风险,1-2级(40%)中度风险。抗凝血药物的使用模式需要不间断的、反复的监测,不仅可以发现治疗效果,而且可以发现潜在的药物不良反应。从服用华法林患者的ha - bled评分分布来看,需要在抗凝治疗开始前后监测参数,特别是INR。关键词:用药评价,抗凝治疗,哈斯-出血评分,心房颤动,出血风险,华法林
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Study of Drug Use Evaluation and Bleeding Risk of Anticoagulants by Has-Bled In Geriatrics
Anticoagulant therapy being the most conventional form of therapeutic intervention is the cornerstone for the treatment and prevention of various ailments including Atrial Fibrillation (AF), Acute Coronary Syndrome (ACS), Venous Thromboembolism (VTE) and patients undertaking cardiac procedures1. Bleeding is the principal complication of anticoagulants even though used within its therapeutic limit. An innovative tool HAS-BLED score come up with the assessment of bleeding risk among patients under anticoagulant therapy supporting the physicians in a better clinical decision making2,3. The objective is to evaluate drug use and bleeding risk of anticoagulant drugs using HAS-BLED Score among geriatric patients. A prospective observational study was conducted in a tertiary care hospital among hundred patients for a period of six months. It was found that 61% were males and 49% were females. Most of the patients were from the age group of 65-70 (53%), 71-75 (31%) and least less than 75 (16%). The most commonly prescribed dosage form was parenteral (79%) and drug was heparin (52%). The bleeding risk of twenty patients taking warfarin was assessed using HAS- BLED Score, the risk categories shows greater than or equal to 3 (60%) high risk and score between 1-2 (40%) moderate risk. Drug use pattern of anticoagulants needs uninterrupted and repeated surveillance not only to discern therapeutic efficacy but also to scrutinize potential adverse drug reaction. From the HAS-BLED score distribution of patients taking warfarin conveys the need to monitor the parameters especially INR before and after initiation of anticoagulant therapy. Keywords: Drug Use Evaluation, Anticoagulant Therapy, HAS-BLED Score, Atrial Fibrillation, Bleeding Risk, Warfarin
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