• Medicina clinica · Nov 2021

    Observational Study

    Mortality in a cohort of primary care patients treated with vitamin K antagonist anticoagulants.

    • David Martín Enguix, Juan Carlos Aguirre Rodríguez, and Abraham Hidalgo Rodríguez.
    • Medicina Familiar y Comunitaria, Centro de Salud Fortuny Velutti, Distrito Sanitario Granada Metropolitano, Granada, España. Electronic address: davidm123m45@hotmail.com.
    • Med Clin (Barc). 2021 Nov 12; 157 (9): 427-433.

    Introduction And ObjectivesThe use of anticoagulants to prevent embolic events in Spain is very high, tending to a progressive increase. For this reason, we intend to analyse the mortality of patients from a metropolitan area of Granada treated with vitamin K antagonist anticoagulants (VKA), over 2 non-consecutive years.Patients And MethodsLongitudinal, observational, retrospective study of 205 patients treated with VKA. Sociodemographic data, previous clinical conditions, pathology causing VKA treatment, degree of control and mortality were collected 2 years after the start of the study.ResultsAverage age, 76±11.8 years (57.56% women). Two-year mortality was 22.4%, with a significant increase depending on age (p<.001) and years of treatment (p<.001). Patients with dementia (p<.05), with chronic kidney disease (p<.01) or with chronic obstructive pulmonary disease (p<.01) also presented higher mortality. Multivariate analysis showed significant effect of chronic kidney disease (odds ratio=4.075), chronic obstructive pulmonary disease (odds ratio=3.694), and years of treatment (odds ratio=1.236).ConclusionsAt 2 years of follow-up, 1 in 5 patients treated with VKA died. The presence of chronic kidney disease, chronic obstructive pulmonary disease and a longer treatment time were independently associated with this increase of mortality. Most of the patients were anticoagulated by atrial fibrillation, they were elderly and had a high prevalence of comorbidities.Copyright © 2020 Elsevier España, S.L.U. All rights reserved.

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