| Abstrak/Abstract |
Stroke in atrial fibrilation patients can increase mortality risk which is a consequence of thromboembolic events.
Thromboprophylaxis can be attained using anticoagulant such as warfarin. However, its administration must be controlled
continously to minimize the bleeding. Anticoagulation control could be done by observing the International Normalized
Ratio (INRs) with the target of 1.5 up to 2.0. An effective control of anticoagulation is expected to lower the mortality rate.
In the study, we investigated the factors affecting the quality of anticoagulation control on warfarin-treated ischemic stroke
patients with atrial fibrilation, and its effect on the clinical outcome i.e. mortality rate. The study was conducted by using
the case control method, in which the patients with the primary diagnosis of ischemic stroke and the secondary diagnosis
of atrial fibrillation receiving warfarin therapy (n = 140). The percentage of the anticoagulation control was evaluated using
INRs to categorize good and poor anticoagulation controls. Based on the multivariate analysis on the 140 subjects, it was
found that the variables which were statistially related to the mortality rate in the hospital were incidence of sepsis (one of
comorbidity) (OR = 6,721; 95% CI = 2,3-19,1; p = 0,000) and the use of aspirin along with warfarin (OR = 0,374; 95% CI
= 1,1-0,9; p = 0,032). However, the anticoagulation control on the warfarin therapy did not significantly affect the mortality
rate at the hospital for ischemic stroke patients with atrial fibrilation (OR = 0,316; 95% CI = 0,6-4,3; p = 1,651). In
conclusion, incidence of sepsis and the use of aspirin along with warfarin are two factors affecting to the mortality,
however, poor anticoagulation control was not related to the mortality rate at the hospital for ischemic stroke patients with
atrial fibrilation using warfarin |
