Audit of patients on oral anticoagulants with International normalized ratios of eight or above. Murphy, P. T., Casey, M. C., & Abrams, K. R. Clinical and Laboratory Haematology, 20(4):253–257, August, 1998. abstract bibtex We reviewed retrospectively the medical records of all patients (n = 77, mean age 74.2) on oral anticoagulants with an International normalized ratio (INR) of eight or above in a 12-month period in the Leicestershire District Health Authority (DHA). From a total of 55,625 INRs, 131 (0.24%) were \textgreater or = 8. A major cause of over-anticoagulation was unsatisfactory dose loading during in-hospital commencement of oral anticoagulation. The incidence of major bleeding was 12.9% of total episodes of INR \textgreater or = 8 with two haemorrhage-related fatalities. Therapy of major haemorrhage with fresh frozen plasma (FFP) and intravenous (i.v) vitamin K proved effective but was not given in a majority of such cases. In conclusion, improvements in initial dose loading of oral anticoagulation and in the management of major haemorrhage are required. Severely over-anticoagulated patients without obvious bleeding should nevertheless receive small dose vitamin K therapy to reduce the risk of haemorrhage related morbidity and mortality without compromising subsequent oral anti-coagulant control.
@article{murphy_audit_1998-1,
title = {Audit of patients on oral anticoagulants with {International} normalized ratios of eight or above},
volume = {20},
issn = {0141-9854},
abstract = {We reviewed retrospectively the medical records of all patients (n = 77, mean age 74.2) on oral anticoagulants with an International normalized ratio (INR) of eight or above in a 12-month period in the Leicestershire District Health Authority (DHA). From a total of 55,625 INRs, 131 (0.24\%) were {\textbackslash}textgreater or = 8. A major cause of over-anticoagulation was unsatisfactory dose loading during in-hospital commencement of oral anticoagulation. The incidence of major bleeding was 12.9\% of total episodes of INR {\textbackslash}textgreater or = 8 with two haemorrhage-related fatalities. Therapy of major haemorrhage with fresh frozen plasma (FFP) and intravenous (i.v) vitamin K proved effective but was not given in a majority of such cases. In conclusion, improvements in initial dose loading of oral anticoagulation and in the management of major haemorrhage are required. Severely over-anticoagulated patients without obvious bleeding should nevertheless receive small dose vitamin K therapy to reduce the risk of haemorrhage related morbidity and mortality without compromising subsequent oral anti-coagulant control.},
language = {eng},
number = {4},
journal = {Clinical and Laboratory Haematology},
author = {Murphy, P. T. and Casey, M. C. and Abrams, K. R.},
month = aug,
year = {1998},
pmid = {9777273},
keywords = {80 and over, Adult, Aged, Anticoagulants, Cardiovascular Diseases, Drug Interactions, Female, Heart Failure, Hemorrhage, Humans, International Normalized Ratio, Male, Medical Audit, Middle Aged, Retrospective Studies, Thrombosis, United Kingdom},
pages = {253--257},
}
Downloads: 0
{"_id":"3GZb9gaJsDpPHuQXs","bibbaseid":"murphy-casey-abrams-auditofpatientsonoralanticoagulantswithinternationalnormalizedratiosofeightorabove-1998","author_short":["Murphy, P. T.","Casey, M. C.","Abrams, K. R."],"bibdata":{"bibtype":"article","type":"article","title":"Audit of patients on oral anticoagulants with International normalized ratios of eight or above","volume":"20","issn":"0141-9854","abstract":"We reviewed retrospectively the medical records of all patients (n = 77, mean age 74.2) on oral anticoagulants with an International normalized ratio (INR) of eight or above in a 12-month period in the Leicestershire District Health Authority (DHA). From a total of 55,625 INRs, 131 (0.24%) were \\textgreater or = 8. A major cause of over-anticoagulation was unsatisfactory dose loading during in-hospital commencement of oral anticoagulation. The incidence of major bleeding was 12.9% of total episodes of INR \\textgreater or = 8 with two haemorrhage-related fatalities. Therapy of major haemorrhage with fresh frozen plasma (FFP) and intravenous (i.v) vitamin K proved effective but was not given in a majority of such cases. In conclusion, improvements in initial dose loading of oral anticoagulation and in the management of major haemorrhage are required. Severely over-anticoagulated patients without obvious bleeding should nevertheless receive small dose vitamin K therapy to reduce the risk of haemorrhage related morbidity and mortality without compromising subsequent oral anti-coagulant control.","language":"eng","number":"4","journal":"Clinical and Laboratory Haematology","author":[{"propositions":[],"lastnames":["Murphy"],"firstnames":["P.","T."],"suffixes":[]},{"propositions":[],"lastnames":["Casey"],"firstnames":["M.","C."],"suffixes":[]},{"propositions":[],"lastnames":["Abrams"],"firstnames":["K.","R."],"suffixes":[]}],"month":"August","year":"1998","pmid":"9777273","keywords":"80 and over, Adult, Aged, Anticoagulants, Cardiovascular Diseases, Drug Interactions, Female, Heart Failure, Hemorrhage, Humans, International Normalized Ratio, Male, Medical Audit, Middle Aged, Retrospective Studies, Thrombosis, United Kingdom","pages":"253–257","bibtex":"@article{murphy_audit_1998-1,\n\ttitle = {Audit of patients on oral anticoagulants with {International} normalized ratios of eight or above},\n\tvolume = {20},\n\tissn = {0141-9854},\n\tabstract = {We reviewed retrospectively the medical records of all patients (n = 77, mean age 74.2) on oral anticoagulants with an International normalized ratio (INR) of eight or above in a 12-month period in the Leicestershire District Health Authority (DHA). From a total of 55,625 INRs, 131 (0.24\\%) were {\\textbackslash}textgreater or = 8. A major cause of over-anticoagulation was unsatisfactory dose loading during in-hospital commencement of oral anticoagulation. The incidence of major bleeding was 12.9\\% of total episodes of INR {\\textbackslash}textgreater or = 8 with two haemorrhage-related fatalities. Therapy of major haemorrhage with fresh frozen plasma (FFP) and intravenous (i.v) vitamin K proved effective but was not given in a majority of such cases. In conclusion, improvements in initial dose loading of oral anticoagulation and in the management of major haemorrhage are required. Severely over-anticoagulated patients without obvious bleeding should nevertheless receive small dose vitamin K therapy to reduce the risk of haemorrhage related morbidity and mortality without compromising subsequent oral anti-coagulant control.},\n\tlanguage = {eng},\n\tnumber = {4},\n\tjournal = {Clinical and Laboratory Haematology},\n\tauthor = {Murphy, P. T. and Casey, M. C. and Abrams, K. R.},\n\tmonth = aug,\n\tyear = {1998},\n\tpmid = {9777273},\n\tkeywords = {80 and over, Adult, Aged, Anticoagulants, Cardiovascular Diseases, Drug Interactions, Female, Heart Failure, Hemorrhage, Humans, International Normalized Ratio, Male, Medical Audit, Middle Aged, Retrospective Studies, Thrombosis, United Kingdom},\n\tpages = {253--257},\n}\n\n","author_short":["Murphy, P. T.","Casey, M. C.","Abrams, K. R."],"bibbaseid":"murphy-casey-abrams-auditofpatientsonoralanticoagulantswithinternationalnormalizedratiosofeightorabove-1998","role":"author","urls":{},"keyword":["80 and over","Adult","Aged","Anticoagulants","Cardiovascular Diseases","Drug Interactions","Female","Heart Failure","Hemorrhage","Humans","International Normalized Ratio","Male","Medical Audit","Middle Aged","Retrospective Studies","Thrombosis","United Kingdom"],"metadata":{"authorlinks":{}}},"bibtype":"article","biburl":"https://bibbase.org/f/FfNE7kWA6pCvwcJZF/myPubs.bib","dataSources":["ZaHtWavQhcwZqKLNF","iRRNaRs6FkffgErta","zeMwFvgpdRkYAkfoD","v8uQmZsBpiqycmskv"],"keywords":["80 and over","adult","aged","anticoagulants","cardiovascular diseases","drug interactions","female","heart failure","hemorrhage","humans","international normalized ratio","male","medical audit","middle aged","retrospective studies","thrombosis","united kingdom"],"search_terms":["audit","patients","oral","anticoagulants","international","normalized","ratios","eight","above","murphy","casey","abrams"],"title":"Audit of patients on oral anticoagulants with International normalized ratios of eight or above","year":1998}