Deep Vein Thrombosis in Severe Motor and Intellectual Disabilities Patients and Its Treatment by Anticoagulants of Warfarin Versus Edoxaban.

Autor:	Ohmori H; Department of Pediatrics, National Hospital Organization Yanai Medical Center, Yanai, Yamaguchi, Japan.; Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Aichi, Japan., Kada A; Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Aichi, Japan., Nakamura M; Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Mie, Japan., Saito AM; Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Mie, Japan., Sanayama Y; Department of Pediatrics, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba, Japan., Shinagawa T; Department of Pediatrics, National Hospital Organization Aomori Hospital, Aomori, Aomori, Japan., Fujita H; Department of Pediatrics, National Hospital Organization Aomori Hospital, Aomori, Aomori, Japan., Wakisaka A; Department of Pediatrics, National Hospital Organization Iou Hospital, Kanazawa, Ishikawa, Japan., Maruhashi K; Department of Pediatrics, National Hospital Organization Iou Hospital, Kanazawa, Ishikawa, Japan., Mizukami A; Department of Pediatrics, National Hospital Organization Toyama Hospital, Toyama, Toyama, Japan., Takizawa N; Department of Pediatrics, National Hospital Organization Toyama Hospital, Toyama, Toyama, Japan., Murata H; Department of Pediatrics, National Hospital Organization Mie Hospital, Tsu, Mie, Japan., Inoue M; Department of Pediatrics, National Hospital Organization Minami-Okayama Medical Center, Tsukubo, Okayama, Japan., Kaneko H; Department of Clinical Research, National Hospital Organization Nagara Medical Center, Gifu, Gifu, Japan., Taniguchi H; Department of Pediatric Neurosurgery, National Hospital Organization Shikoku Medical Center for Children and Adults, Zentsuji, Kagawa, Japan., Sano N; Department of Pediatrics, National Hospital Organization Minami-Kyushu Hospital, Aira, Kagoshima, Japan., Tanuma N; Department of Pediatrics, Tokyo Metropolitan Fuchu Medical Center for the Disabled, Fuchu, Tokyo, Japan., Kumode M; Department of Pediatrics, Biwako Gakuen Kusatsu Medical and Welfare Center, Kusatsu, Shiga, Japan., Takechi T; Department of Pediatrics, National Hospital Organization Kochi Hospital, Kochi, Kochi, Japan., Koretsune Y; National Hospital Organization Osaka National Hospital, Osaka, Osaka, Japan., Sumimoto R; National Hospital Organization Yanai Medical Center, Yanai, Yamaguchi, Japan., Miyanomae T; National Hospital Organization Minami Kyoto Hospital, Joyo, Kyoto, Japan.
Jazyk:	angličtina
Zdroj:	Annals of vascular diseases [Ann Vasc Dis] 2019 Sep 25; Vol. 12 (3), pp. 372-378.
DOI:	10.3400/avd.oa.19-00040
Abstrakt:	Objective : Patients with severe motor and intellectual disabilities (SMID) often develop complications, including paralysis of the extremities due to abnormal muscular tonicity. Furthermore, the incidence of sudden death, which may be caused by pulmonary thromboembolism (PTE), is approximately 4.2%. Deep vein thrombosis (DVT) is attracting attention as an embolic source. In this study, DVT was confirmed in SMID patients by lower extremity venous ultrasound. The oral anticoagulant, warfarin, and novel oral anticoagulant, edoxaban tosilate hydrate, were administered, and their efficacies and safeties were evaluated. Materials and Methods : DVT patients were randomly allocated to warfarin and edoxaban groups. The frequency of hemorrhagic events and incidence of adverse events were investigated to evaluate efficacy and safety. Results : DVT was detected in 14 (8.4%) out of 167 patients. Four (0.067/person-month) hemorrhagic events occurred in the warfarin group from subcutaneous hemorrhage due to bruises caused by postural changes. Three (0.042/person-month) events occurred in the edoxaban group due to nasal hemorrhage caused by tracheal aspiration. There was no significant difference (p=0.5383) between groups. Conclusion : No significant differences were observed in hemorrhagic events between SMID patients with DVT treated with warfarin and edoxaban. Competing Interests: Disclosure StatementMashio Nakamura and Yukihiro Koretsune received honoraria from Daiichi Sankyo Company, Limited. The other authors do not have any conflicts of interest to declare. (Copyright © 2019 Annals of Vascular Diseases.)
Databáze:	MEDLINE
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