Assessment of an age-adjusted warfarin initiation protocol
| Autor: | Alexander Gallus, Vaughn Eaton, David G Cosh, Iwona Jensen, Cathrine B M Nielsen, Trine Helboe, Gregory W Roberts |
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| Rok vydání: | 2003 |
| Předmět: |
0301 basic medicine
Adult Male medicine.medical_specialty Age adjustment Plasma albumin level 030204 cardiovascular system & hematology Loading dose Drug Administration Schedule 03 medical and health sciences 0302 clinical medicine Internal medicine Medicine Humans Pharmacology (medical) Dosing International Normalized Ratio Prospective Studies Prospective cohort study Blood Coagulation Aged Proportional Hazards Models Aged 80 and over business.industry Proportional hazards model Warfarin Age Factors Reproducibility of Results Middle Aged Surgery 030104 developmental biology Treatment Outcome Female business Low serum albumin medicine.drug |
| Zdroj: | Flinders University PURE |
| ISSN: | 1060-0280 |
| Popis: | OBJECTIVE: To examine the time taken to reach a stable international normalized ratio (INR), as well as the incidence of overanticoagulation of an age-adjusted warfarin initiation protocol. METHODS: Inpatients and outpatients commencing warfarin therapy at 2 teaching hospitals were dosed according to the age-adjusted protocol. Data were collected prospectively. MAIN OUTCOME MEASURES: Time to reach a stable INR of 2–3 and the number of patients experiencing an INR ≥4 during the first week of warfarin therapy. RESULTS: Seventy-three patients were assessed; at the completion of the 4-day titration protocol, 63% had achieved a stable INR. After an additional 2 days of empiric dosage adjustment by the attending physician, 86% of the subjects demonstrated a stable INR. Five patients (7%) experienced an INR ≥4. These patients had a nonsignificant trend toward a lower plasma albumin level compared with other patients (p = 0.057, Student's t-test). The INR-driven dose adjustments on days 3 and 4 of this protocol coped with other variables that have been shown to affect maintenance warfarin dosing. These included weight, gender, pharmacologic factors affecting clearance, and the presence of certain predesignated risk factors. CONCLUSIONS: The age-adjusted dosing protocol rapidly achieved a stable INR with minimal overanticoagulation. Patients with low serum albumin levels ( |
| Databáze: | OpenAIRE |
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