Abstract
Background A lot of drug groups are associated with preventable drug-related admissions. Coumarin derivatives, prescribed for the treatment and prevention of deep vein thrombosis or pulmonary embolism or prevention of systemic embolism or stroke in patients with prosthetic heart valves or atrial fibrillation, are often associated with bleeding. The aim of our study was to estimate the impact of the anticoagulant therapy in the elderly population (over 65 years old) living in Grosseto province, through the hospitalizations and the visits to emergency room, using only current data flows.
Methods In 2013 we conducted a cross sectional study analyzing the database of all pharmaceutical prescriptions, selecting patients living in Grosseto (Italy), which received at least two prescriptions of coumarin derivatives in 2012. We analyzed the admissions to hospital and the accesses to the emergency rooms (ER) made by each patient, focusing especially on those related to bleeding. For each access to ER we recorded the date, time of stay, diagnosis and outcome. For each hospitalization the information we recorded were the date of admission and discharge diagnosis.
Results 3684 patients were included in our study. 261 (7.1%) patients visited the emergency room for bleeding; 37 (1%) for intracranial bleeding. The accesses made by men were higher than those made by women. The average time of stay in ER was 349 minutes. The admissions to hospital were 96 (2.6%); 42 (1.1%) were admitted to hospital with a diagnosis of major vascular event. 53 patients (20.3 %), accessed to the ER more than one time. The 11.5% was admitted to the hospital more than one time.
Conclusions Our study tried to estimate the impact of the anticoagulant therapy in the elderly population, living in Grosseto province, showing an important impact of this therapy on the accesses at ER and on admissions at hospital.
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