{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T16:44:44Z","timestamp":1726505084788},"reference-count":4,"publisher":"California Digital Library (CDL)","issue":"4","license":[{"start":{"date-parts":[[2020,6,14]],"date-time":"2020-06-14T00:00:00Z","timestamp":1592092800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Case Presentation: A 63-year-old female presented to the emergency department complaining of cough, neck swelling, dysphagia, and dysphonia for two days, with a past medical history of atrial fibrillation managed with warfarin. Investigations revealed a supratherapeutic international normalised ratio (greater than 10). Imaging and endoscopic examination showed an extensive retropharyngeal hematoma with significant mass effect on the airway.\n\nDiscussion: A rare but potentially fatal complication of warfarin anticoagulation is upper airway hematoma, with violent coughing described as an inciting cause. Signs of airway compromise necessitate specialist consultation and definitive airway management, while mild cases without airway concerns can be managed conservatively with medical anticoagulation reversal.<\/jats:p>","DOI":"10.5811\/cpcem.2020.7.48695","type":"journal-article","created":{"date-parts":[[2020,11,17]],"date-time":"2020-11-17T06:12:53Z","timestamp":1605593573000},"page":"634-635","source":"Crossref","is-referenced-by-count":1,"title":["Extensive Upper Airway Hematoma Secondary to Supratherapeutic Warfarin Anticoagulation"],"prefix":"10.5811","volume":"4","author":[{"given":"Taofiq","family":"Oyedokun","sequence":"first","affiliation":[{"name":"University of Saskatchewan, Department of Emergency Medicine, Saskatoon,  Saskatchewan, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Durr","sequence":"additional","affiliation":[{"name":"University of Ottawa, Department of Emergency Medicine, Ottawa, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"29705","published-online":{"date-parts":[[2020,6,14]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Karmacharya P, Pathak R, Ghimire S, et al. Upper airway hematoma secondary to warfarin therapy: a systematic review of reported cases. N Am J Med Sci. 2015:7(11):494-502.","DOI":"10.4103\/1947-2714.170606"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Ako\u011flu E, Seyfeli E, Ako\u011flu S, et al. Retropharyngeal hematoma as a complication of anticoagulation therapy. Ear Nose Throat J. 2008:87(3):156-9.","DOI":"10.1177\/014556130808700312"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Bloom D, Haegen T, Keefe M. Anticoagulation and spontaneous retropharyngeal hematoma. J Emerg Med. 2003:24(4):389-94.","DOI":"10.1016\/s0736-4679(03)00035-0"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Hickey M, Gatien M, Taljaard M, et al. Outcomes of urgent warfarin reversal with frozen plasma versus prothrombin complex concentrate in the emergency department. Circulation. 2013:128(4):360-4.","DOI":"10.1161\/circulationaha.113.001875"}],"container-title":["Clinical Practice and Cases in Emergency Medicine"],"original-title":[],"deposited":{"date-parts":[[2020,11,19]],"date-time":"2020-11-19T20:22:57Z","timestamp":1605817377000},"score":1,"resource":{"primary":{"URL":"https:\/\/escholarship.org\/uc\/item\/6bd8v8sm"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,14]]},"references-count":4,"issue-title":["Clinical Practice and Cases in Emergency Medicine"],"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020,11,10]]}},"URL":"https:\/\/doi.org\/10.5811\/cpcem.2020.7.48695","relation":{},"ISSN":["2474-252X","2474-252X"],"issn-type":[{"type":"electronic","value":"2474-252X"},{"type":"print","value":"2474-252X"}],"subject":[],"published":{"date-parts":[[2020,6,14]]}}}