Jurnal Profesi Medika: Jurnal Kedokteran dan Kesehatan
Vol 14, No 2 (2020): Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan

Evaluating the Use of Warfarin Using the HAS-BLED Score and INR on Atrial Fibrillation Patients at Harapan Kita National Heart Center

Meva Sari Chandra (Universitas Pancasila)
Shirly Kumala (Universitas Pancasila)
Sesilia Andriani Keban (Universitas Pancasila)



Article Info

Publish Date
16 Dec 2020

Abstract

Patients with atrial fibrillation are associated with a 4-5-fold risk of having a stroke. The most effective treatment for atrial fibrillation is to prevent the formation of blood clots by administering anticoagulant drugs. Warfarin is an anticoagulant drug that has a narrow therapeutic index with side effects of the risk of bleeding; hence it needs supervision in its use. In this study, the HAS-BLED score was used to measure major bleeding risk and as a value representing each risk factor for bleeding. The bleeding risk can be prevented by maintaining a warfarin response in the therapeutic range with an INR (International Normalized Ratio) measurement 2-3. This study was an observational study conducted with retrospective data collection through medical records of patients with a primary diagnosis of atrial fibrillation who received oral warfarin anticoagulant therapy at Harapan Kita National Heart Center in the period of January-December 2017. Using a sample of 40 patients who met the inclusion criteria. According to the data, found that atrial fibrillation patients who received oral warfarin therapy 55% were male patients, while 45% were female patients. Patients with atrial fibrillation who got the most oral warfarin therapy were patients who were over 40 years old with 90% of the total sample, with the highest group in patients aged 50-54 years with 22.5%. The HAS-BLED values arranged from 0-9, the percentage of patients who had HAS-BLED values of 0, 1, 2 respectively at 7.5%, 42.5%, 30%. The HAS-BLED score ≥ 3 showed patients classified as at high risk of bleeding by 20%. The most risk factors based on HAS-BLED score from all study samples were 18 patients with abnormal kidney or 45%. The average INR score in patients at high risk of bleeding showed that 37.5% had an average INR score in the target ratio score of INR 2-3.

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