Center-Related Determinants of VKA Anticoagulation Quality: A Prospective, Multicenter Evaluation
| Autor: | Tosetto, A, Manotti, C, Marongiu, F, Italian Federation of Anticoagulation Clinics (FCSA) clinical quality study group, Serino, Maria Luisa |
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| Rok vydání: | 2015 |
| Předmět: |
Male
endocrine system medicine.medical_specialty MEDLINE lcsh:Medicine NO Humans Medicine Center (algebra and category theory) International Normalized Ratio Prospective Studies lcsh:Science Prospective cohort study Aged Quality of Health Care Anticoagulant monitoring Aged 80 and over Multidisciplinary business.industry lcsh:R Anticoagulants nutritional and metabolic diseases Atrial fibrillation medicine.disease Meta-analysis Emergency medicine Physical therapy Female lcsh:Q Observational study Drug Monitoring business Anticoagulation clinic Research Article |
| Zdroj: | PLoS ONE, Vol 10, Iss 12, p e0144314 (2015) PLoS ONE |
| ISSN: | 1932-6203 |
| Popis: | Background Center-specific TTR (c-TTR) is a measure reporting the mean patient TTR within an anticoagulation clinic describing the quality of anticoagulant monitoring offered by that clinic. c-TTR has a considerable between-center variation, but its determinants are poorly understood. Objectives We aimed at evaluating which clinical, procedural or laboratory factors could be associated with c-TTR variability in a multicenter, observational cross-sectional study over a five-year period. Patients/Methods Data from 832,204 individual patients followed for VKA therapy in 292 Centers affiliated with the Italian Federation of Anticoagulation Clinics (FCSA) were analyzed. c-TTR was computed based on the TTR of patients followed at each Center, and a mixed linear regression model was used for a predefined set of explanatory variables. Results The Center next-visit interval ratio (the mean number of days after a visit with an INR outside the therapeutic range, divided by the days after a visit with an INR within the therapeutic range), the Center mean patient INR and the Center laboratory performance at EQA proficiency testing were the only variables that were independently associated with c-TTR (β-coefficients -17.32, 9.67, and -0.11, respectively; r2 = 0.635). Conclusions These findings suggest that c-TTR associates with proactive strategies aimed at keeping patients very close to their target INR with a prompt re-evaluation of those patients with under- or over-therapeutic INR. |
| Databáze: | OpenAIRE |
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