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Are patients on warfarin with high INR treated according to published guidelines?

Le-Kim, Lucia and Kerr, Debra and Kelly, Anne-Maree (2009) Are patients on warfarin with high INR treated according to published guidelines? Internet Journal of Hemotology, 5 (1). ISSN 1540-2649

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Abstract

Objective: Australasian guidelines for the treatment of over-anticoagulation have been published. We aimed to determine whether emergency department [ED] patients taking warfarin who have high INR were treated according to guidelines. Methods: This retrospective observational study included ED patients taking warfarin with INR ≥ 4. Data included demographics, warfarin indication, bleeding evidence and subsequent management. Outcome of interest was proportion treated according to guidelines; analysed by descriptive statistics. Results: 201 patients were studied; median age 74 years, 47% female. Atrial fibrillation was the main indication for warfarin [63%]. 48 patients [24%] presented with bleeding, of which 22 were classified as major bleeds. All patients with major bleeding received reversal treatment; with 64% receiving recommended triple therapy. 33% in the non-bleeding group received reversal treatment. Conclusion: There was reasonably good compliance with the guidelines, especially for patients with major bleeding. Vitamin K doses were suboptimal in a significant proportion of cases.

Item Type: Article
Uncontrolled Keywords: ResPubID17133, warfarin, INR, anticoagulation
Subjects: Faculty/School/Research Centre/Department > School of Nursing and Midwifery
FOR Classification > 1199 Other Medical and Health Sciences
SEO Classification > 970111 Expanding Knowledge in the Medical and Health Sciences
Depositing User: VUIR
Date Deposited: 04 May 2012 00:13
Last Modified: 04 May 2012 00:13
URI: http://vuir.vu.edu.au/id/eprint/4403
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Citations in Scopus: 2 - View on Scopus

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