September 18, 2001Annals of Internal Medicine
Clinical Predictors of Prolonged Delay in Return of the International Normalized Ratio to within the Therapeutic Range after Excessive Anticoagulation with Warfarin
Key result
Decompensated congestive heart failure (OR 2.79; 95% CI 1.30-5.98) and active cancer (OR 2.48; 95% CI 1.11-5.57) strongly predicted delayed INR normalization (≥4.0) on day 2.
Population
633 outpatients with an initial INR greater than 6.0 in whom two doses of warfarin were withheld and a…
Design
Cohort
Follow-up
2 days
Authors
Discussion
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Implication
Steady-state warfarin dose, advanced age, extreme INR elevation, decompensated heart failure, and active cancer are significant predictors of a prolonged delay in INR normalization after withholding warfarin.
Study Design
Type
Cohort (n=633)
Structured PICO
P
Population
633 outpatients with an initial INR > 6.0 who had two doses of warfarin withheld and no vitamin K1 administered, evaluated for INR normalization on day 2.
E
Exposure
Withholding two doses of warfarin
O
Outcome
INR of 4.0 or greater on day 2 after two doses of warfarin were withheldsurrogate
Main Result
Odds Ratio: 2.79 (95% CI 1.3–5.98)
Steady-state warfarin dose, advanced age, extreme INR elevation, decompensated heart failure, and active cancer are significant predictors of a prolonged delay in INR normalization after withholding warfarin.
Cite This Study
Hylek et al. (2001) conducted a cohort in Excessive anticoagulation with warfarin (n=633). Decompensated congestive heart failure vs. Absence of decompensated congestive heart failure was evaluated on INR of 4.0 or greater on day 2 (OR 2.79, 95% CI 1.30-5.98). Decompensated congestive heart failure (OR 2.79; 95% CI 1.30-5.98) and active cancer (OR 2.48; 95% CI 1.11-5.57) strongly predicted delayed INR normalization (≥4.0) on day 2.