Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias · 2017
[Nontherapeutic international normalized ratio results in hospital emergency patients on vitamin K antagonists: prevalence and associated factors].
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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López Altimiras Xavier, Gené Tous Emili, De Giorgi Antonio, Gadea Polo Andrés, Martín Horcajo Raquel, Jiménez Hernández Sònia
Аннотация
OBJECTIVES: To determine the prevalence of international normalized ratio (INR) findings outside the normal range in hospital emergency department patients on vitamin K antagonists (VKAs). To identify factors associated with abnormal anticoagulant levels in these patients.
MATERIAL AND METHODS: Observational, cross-sectional, multicentric study in 4 hospital emergency departments. We included a convenience sample of patients on VKA treatment for whom INR levels were on record and who had sought emergency care for complications unrelated to anticoagulant treatment.
RESULTS: We included 376 patients with a mean (SD) age of 76.8 (10.1) years; 50.3% were women and 86.7% had atrial fibrillation. We found that 60.4% (95% CI, 55.3%-65.2%) had INRs outside the reference range. Multivariate analysis showed that changes in the patients' other long-term medications were independently associated with nontherapeutic INR results (odds ratio, 1.6; 95% CI, 1.02-2.79; P=.035).
CONCLUSION: Over 60% of patients on VKA treatment who come to hospital emergency departments with complaints unrelated to anticoagulant therapy have INR values outside the normal range. Changes in a patient's usual medications are significantly associated with nontherapeutic INR findings.
MATERIAL AND METHODS: Observational, cross-sectional, multicentric study in 4 hospital emergency departments. We included a convenience sample of patients on VKA treatment for whom INR levels were on record and who had sought emergency care for complications unrelated to anticoagulant treatment.
RESULTS: We included 376 patients with a mean (SD) age of 76.8 (10.1) years; 50.3% were women and 86.7% had atrial fibrillation. We found that 60.4% (95% CI, 55.3%-65.2%) had INRs outside the reference range. Multivariate analysis showed that changes in the patients' other long-term medications were independently associated with nontherapeutic INR results (odds ratio, 1.6; 95% CI, 1.02-2.79; P=.035).
CONCLUSION: Over 60% of patients on VKA treatment who come to hospital emergency departments with complaints unrelated to anticoagulant therapy have INR values outside the normal range. Changes in a patient's usual medications are significantly associated with nontherapeutic INR findings.