Pharmacy, Health Sciences & Exercise Science
Risk Factors Associated with Excessive Anticoagulation in Inpatient Treatment with Warfarin
Document Type
Oral Presentation
Location
Indianapolis, IN
Subject Area
Pharmacy, Health Sciences & Exercise Science
Start Date
10-4-2015 10:45 AM
End Date
10-4-2015 12:00 PM
Sponsor
Carrie Jung (Butler University)
Description
Risk Factors Associated with Excessive Anticoagulation in Inpatient Treatment with Warfarin
Justin Donat, PharmD Candidate. Preceptor: Carrie Jung, PharmD
Background: Warfarin is an oral anticoagulant often utilized in hospitalized patients. Many factors exist which may affect the degree of anticoagulation warfarin provides. While many factors have been studied in the outpatient setting which affect the international normalized ration (INR), studies examining factors affecting the INR in hospitalized patients receiving warfarin are currently lacking in data.
Methods: A retrospective chart review of patients at the Sidney and Lois Eskenazi Hospital was completed. Patients were included if they were hospitalized between January 1, 2014- September 30, 2014, received at least one dose of warfarin, were 18yrs of age or older, were not scheduled to undergo surgery, and had an INR >5 during admission. Variables which were assessed included various drug interactions, presence of hepatic malignancy, poor nutritional status, diarrhea within 24 hours of the elevated INR, decompensated heart failure, transition from enteral/parenteral nutrition or NPO status to oral feeding within 48 hours of elevated INR, end-stage renal disease, and hepatic insufficiency.
Results: 29 patients with a mean age of 59.8 years were included in analysis. The mean INR upon admission was 2.358. The most common potential risk factors present in the population were use of moderate warfarin potentiating medications (8 patients; 27.6%) and decompensated heart failure (11 patients; 37.9%). The least common potential risk factor was hepatic malignancy (0 patients; 0%). The most prevalent number of concurrent risk factors present was one (9 patients; 31.03%).
Conclusions: Statistical significance cannot be determined from the results of this study due to it being descriptive in nature. However, the data gathered on these patients could be utilized in future research by comparing it to data gathered on control patients from Eskenazi's inpatient population.
Risk Factors Associated with Excessive Anticoagulation in Inpatient Treatment with Warfarin
Indianapolis, IN
Risk Factors Associated with Excessive Anticoagulation in Inpatient Treatment with Warfarin
Justin Donat, PharmD Candidate. Preceptor: Carrie Jung, PharmD
Background: Warfarin is an oral anticoagulant often utilized in hospitalized patients. Many factors exist which may affect the degree of anticoagulation warfarin provides. While many factors have been studied in the outpatient setting which affect the international normalized ration (INR), studies examining factors affecting the INR in hospitalized patients receiving warfarin are currently lacking in data.
Methods: A retrospective chart review of patients at the Sidney and Lois Eskenazi Hospital was completed. Patients were included if they were hospitalized between January 1, 2014- September 30, 2014, received at least one dose of warfarin, were 18yrs of age or older, were not scheduled to undergo surgery, and had an INR >5 during admission. Variables which were assessed included various drug interactions, presence of hepatic malignancy, poor nutritional status, diarrhea within 24 hours of the elevated INR, decompensated heart failure, transition from enteral/parenteral nutrition or NPO status to oral feeding within 48 hours of elevated INR, end-stage renal disease, and hepatic insufficiency.
Results: 29 patients with a mean age of 59.8 years were included in analysis. The mean INR upon admission was 2.358. The most common potential risk factors present in the population were use of moderate warfarin potentiating medications (8 patients; 27.6%) and decompensated heart failure (11 patients; 37.9%). The least common potential risk factor was hepatic malignancy (0 patients; 0%). The most prevalent number of concurrent risk factors present was one (9 patients; 31.03%).
Conclusions: Statistical significance cannot be determined from the results of this study due to it being descriptive in nature. However, the data gathered on these patients could be utilized in future research by comparing it to data gathered on control patients from Eskenazi's inpatient population.