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Master Thesis

Gestion des accidents hémorragiques sous Anticoagulants Oraux Directs dans une structure d’urgence en 2013. Étude observationnelle rétrospective transversale et analyse des pratiques aux Urgences de Libourne et Sainte Foy la Grande du 01/09/2013 au 31/12/ 2013

Abstract : The thromboembolic disease is common with a significant morbidity and mortality. It involves the use of anticoagulant treatment of hemorrhagic accidents, which can be life-threatening. The direct oral Anticoagulants (AOD) are new therapeutic, as an alternative to the Anti-vitamines K, for which effectiveness involves more biological monitoring, but however there is no even antidotes or recommendations concerning support for iatrogenic bleeding. We wanted to evaluate how this support was handled in an emergency structure. Our study is part of the analysis of the practices of the support of the AOD bleeding emergencies of Libourne from 13-09-01 31/12/13. 169 patients on 14.378 inclusions presented iatrogenic hemorrhage which 95 patients on antiplatelet agents, anti-vitamines K 75 patients, 3 patients receiving injectable heparins and 17 patients on AOD. The ground (age, background, treatment related), biology (NFS, platelets, hemostasis, functions kidney and liver), setting up Hemostatic measures (reversions, transfusions), duration of hospitalization and the future served basis for our assessment. 14 patients on 17 under ODA received blood transfusion. The supports have been mostly heterogeneous, depending on the expertise of the team present and not in accordance with the proposals of the Group of interest of hemostasis in Peri-operatoire (GIHP). In order to standardize the practices, we proposed at the end of our study a service protocol for management of hemorrhagic event under ODA, in consultation with other specialties of the hospital, reflex sheets for the cardiologist, the practitioner and the patient.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01093083
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Wednesday, December 10, 2014 - 10:34:48 AM
Last modification on : Wednesday, August 23, 2017 - 4:41:21 PM
Long-term archiving on: : Wednesday, March 11, 2015 - 10:27:07 AM

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Juliane Bosc. Gestion des accidents hémorragiques sous Anticoagulants Oraux Directs dans une structure d’urgence en 2013. Étude observationnelle rétrospective transversale et analyse des pratiques aux Urgences de Libourne et Sainte Foy la Grande du 01/09/2013 au 31/12/ 2013. Médecine humaine et pathologie. 2014. ⟨dumas-01093083⟩

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