January 20, 2011

At War With Warfarin

(Ivanhoe Newswire) -- More than 31 million prescriptions were written for warfarin in 2004. Now, researchers have reason to believe that the anticoagulant drug may be linked to post-injury death.

The drug, which is used to prevent various types of blood clot formations and for abnormal heart rhythm, mechanical heart valves and, in certain cases, heart attack, was scrutinized by Vanderbilt University Medical Center researchers in a recent study set for publication in the Archives of Surgery's May print issue. Led by Lesly A. Dossett, M.D., M.P.H., the research team looked at the National Trauma Databank to compile data for the over 1.2 million men and women who went to trauma centers between the years 2002 and 2007.

About 3 percent of these patients who were under 65, and 9 percent who were over 65, used warfarin, and the total number of warfarin users nearly doubled from 2002 to 2006 (2.3 percent to 4 percent).

In all, the warfarin users were found to be 4.5 percent more likely to die from their traumatic injury than their counterparts. This group was also more likely to experience injuries in their home, bleeding in the brain, blunt mechanism injuries, and overall, had a higher amount of severe injuries. The younger warfarin users were especially at risk, as the drug was found to increase severe head injury mortality by 50 percent.

"These data support other reports that suggest that patients who undergo pre-injury anticoagulation with warfarin are at increased risk of death after trauma," the authors wrote. "Warfarin prescribers should consider these data in the overall risk-benefit analysis when opting to prescribe warfarin, and these data provide further rationale for discontinuing warfarin when the clinical evidence no longer supports its use."

Source: Archives of Surgery, January 2011