Key result
VKA overcoagulation drives ~1% of ED admissions, linked to female gender, fever, and interacting medications.
Why the study?
Factors associated with vitamin K antagonist overcoagulation and related morbidity in unselected patients were not well defined.
What are the clinical risk factors associated with vitamin K antagonist overcoagulation in unselected emergency department patients?
Population
4,188 consecutive unselected patients referred to an Emergency Department over two months
Comparison
VKA-treated patients with INR >6.0 or INR 4.0-6.0 with bleeding vs age- and sex-matched VKA-treated controls without overcoagulation
Design
Case-control study
Authors
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May support enhanced INR monitoring for VKA patients with interacting drugs or fever; hypothesis-generating for prospective prevention trials.
Case-Control (n=150)
No
What are the clinical risk factors associated with vitamin K antagonist overcoagulation in unselected emergency department patients?
Vitamin K antagonist overcoagulation is a significant cause of emergency admissions, strongly associated with specific drug interactions (antibiotics, amiodarone, PPIs) and intercurrent illness (fever).
Cadiou et al. (2008) conducted a case-control in Vitamin K antagonist overcoagulation (n=150). Risk factors (female gender, previous high INR, antibiotics, amiodarone, PPIs, fever) vs. Matched controls without overcoagulation was evaluated on Factors associated with INR > 6.0 or 4.0-6.0 with bleeding. Risk factors including female gender (67% of cases), previous high INR, antibiotics, amiodarone, PPIs, and fever were associated with VKA overcoagulation, which caused 1.19% of ED admissions.
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