PB1009 - Assessment and Management of Toxic Coagulopathies at the Yeolyan Hematology and Oncology center: A 7-Year Retrospective Analysis (2016-2022)

Tuesday, June 25, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Presenting Author(s)

Heghine S. Khachatryan, MD, PhD

Head of Hemophilia and Thrombosis Center
Hemophilia and Thrombosis Center, Yeolyan Hematology and Oncology Center, Yerevan Armenia YSMU, department of Hematology and Pediatric oncology
Yerevan, Yerevan, Armenia

Co-Author(s)

AS

Arakelyan Samvel

hematologist
Armenian Hemophilia and Trombosis center
Yerevan, Yerevan, Armenia
AS

Armine Sahakyan

hematologist
"Yeolyan" Hematology and Oncology Center Ministry of Health, Republic of Armenia
Yerevan, Yerevan, Armenia
NJ

Nara Jatin

Resident
Armenian Hemophilia and Trombosis center
Yerevan, Yerevan, Armenia
KB

Khushi Bari

Resident
Armenian Hemophilia and Trombosis center
Yerevan, Yerevan, Armenia
Nelli S. Sargsyan

Hematologist
Hemophilia and Thrombosis Center, Yeolyan Hematology and Oncology Center, Yerevan, Armenia
Yerevan, Yerevan, Armenia
Liana G. Hambardzumyan, Master's degree

Hematologist
Hemophilia and Thrombosis Center, Yeolyan Hematology and Oncology Center, Yerevan, Armenia
Yerevan, Yerevan, Armenia
LP

Lilit S. Petrosyan

hematologist
Hemophilia and Thrombosis Center, Yeolyan Hematology and Oncology Center, Yerevan, Armenia
Yerevan, Yerevan, Armenia
CS

Clodet Stepanians

Hematologist
Hemophilia and Thrombosis Center, Yeolyan Hematology and Oncology Center, Yerevan, Armenia
Yerevan, Yerevan, Armenia
GT

Gevorg N. Tamamyan

Professor, hematologist-oncologist
Armenian Hemophilia and Trombosis center
Yerevan, Yerevan, Armenia
SD

Samvel H. Danelyan

hematologist-oncologist, Head of Yeolyan Oncology and Hematology Center
Armenian Hemophilia and Trombosis center
Yerevan, Yerevan, Armenia
LS

Lusine Sahakyan

hematologist
Armenian Hemophilia and Trombosis center
Yerevan, Yerevan, Armenia

Background: Accidental or intentional exposure to rodenticides, particularly superwarfarins with prolonged anticoagulant effects, poses a critical threat to human life, constituting a significant public health concern.

Aims: This study aimed to comprehensively assess the incidence, severity, prognosis, and therapeutic outcomes of toxic coagulopathy (TC) in Armenia during the period 2016-2022.

Methods: Conducted as an observational cohort study from January 2016 to December 2022, this research focused on 149 patients with coagulopathies diagnosed and treated at the Thrombosis and Hemophilia Center within the Yeolyan Hematology and Oncology center.

Results: Over the study duration, 56 patients (37.6% of the total) with TC were identified, comprising 36 males (64.3%) and 20 females (35.7%). Among these patients, 70% were adults, and 30% were children. Notably, 52% of TC cases originated from Armavir and Syunik, regions where an outbreak of zoo coumarin-associated poisoning occurred in 2018-2019 due to improper fertilizer use. Predominantly affected age groups included 45-65 years (32.1%), 19-28 years (19.6%), and 29-45 years (14.3%). Hospitalized TC patients received vitamin K1 preparations, fresh frozen plasma, erythrocyte suspensions, and symptomatic therapy for 7-10 days, followed by outpatient monitoring and treatment for 6-12 months. While most cases showed positive outcomes, there was one fatality in 2018 (hemorrhagic stroke) due to treatment refusal, and instances of repeated poisonings were also recorded.

Conclusion(s): Effective identification and timely management of toxic coagulopathies necessitate coordinated efforts from toxicologists, resuscitators, and hemostasiologists, significantly enhancing patient care. Primary care physicians' vigilance toward detecting hemorrhagic syndromes of unknown origin should be heightened to improve overall awareness and response.