Key result
Joint or soft tissue aspirations and injections in patients taking stable doses of warfarin sodium resulted in zero cases of significant hemorrhage among 32 procedures (risk <10% with 95% certainty).
Why the study?
Are joint or soft tissue aspirations and injections safe in patients taking stable doses of warfarin sodium?
Observational (n=32)
Are joint or soft tissue aspirations and injections safe in patients taking stable doses of warfarin sodium?
Joint and soft tissue aspirations and injections can be safely performed in patients on stable warfarin therapy with a low risk of hemorrhage.
Answers are grounded in this paper and cite their sources.
May support low-bleeding-risk procedures on stable warfarin; leaves open need for larger prospective confirmation.
OBJECTIVE: To determine the safety of joint or soft tissue aspirations and injections in patients taking warfarin sodium. METHODS: The outcome of 32 joint or soft tissue aspirations or injections in patients receiving stable doses of warfarin sodium was assessed through a standardized interview 4 weeks after the procedure. The primary outcome measure was significant joint or soft tissue hemorrhage, ascertained by patient-reported increases in swelling or warmth at the procedure site. RESULTS: None of 32 procedures was complicated by joint or soft tissue hemorrhage reported by the patients, yielding, by the "rule of threes," a risk of significant hemorrhage of < 10% (with 95% certainty). Diagnostic information was obtained for 53% of aspirated sites (8 of 15) and therapeutic benefit was noted in 74% of corticosteroid-injected sites (17 of 23). CONCLUSION: Joint or soft tissue injections and aspirations in selected patients taking warfarin sodium are associated with a low risk of hemorrhage and are often of diagnostic or therapeutic value.
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Thumboo et al. (1998) conducted an observational in Patients taking warfarin sodium (n=32). Joint or soft tissue aspirations and injections was evaluated on Significant joint or soft tissue hemorrhage (risk < 10%). Joint or soft tissue aspirations and injections in patients taking stable doses of warfarin sodium resulted in zero cases of significant hemorrhage among 32 procedures (risk <10% with 95% certainty).
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