| Patient-specific factors predictive of warfarin dosage requirements. | |
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MedLine Citation:
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PMID: 12243598 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To identify patient-specific factors predictive of maintenance warfarin dosage requirements >5 mg/d. METHODS: One hundred forty-six adults taking warfarin were identified from a community hospital and an outpatient anticoagulation clinic. Patient demographics and data on warfarin doses, laboratory results, and medication use were obtained by abstracting patient records. Estimates of vitamin K intake were obtained using a questionnaire and structured interview. Multiple logistic regression was used to identify patient characteristics independently predictive of warfarin maintenance requirements >5 mg/d. An assessment tool for estimating an individual patient's likelihood of requiring warfarin maintenance doses >5 mg/d was derived from the logistic regression model and was assessed in both the study cohort and a separate historical validation cohort of 125 patients. RESULTS: Five factors were independently associated with warfarin requirements >5 mg/d: age <55 years, male gender, African American ethnicity, vitamin K intake >400 micro g/d, and body weight >or=91 kg. The assessment tool derived from these factors correctly classified semiquantitative warfarin requirements as non-high-dose in 84 of 93 study cohort patients and 71 of 78 validation cohort patients, and correctly classified requirements as high-dose in 10 of 13 study cohort patients and 11 of 15 validation cohort patients. CONCLUSIONS: African American ethnicity is a newly identified predictor of warfarin requirements >5 mg/d and is independent of dietary vitamin K intake. An assessment tool incorporating this and other predictors can estimate a patient's likelihood of requiring such dosages. |
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Authors:
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Randall K Absher; M Elisabeth Moore; Mary H Parker |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: The Annals of pharmacotherapy Volume: 36 ISSN: 1060-0280 ISO Abbreviation: Ann Pharmacother Publication Date: 2002 Oct |
Date Detail:
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Created Date: 2002-09-23 Completed Date: 2003-04-25 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9203131 Medline TA: Ann Pharmacother Country: United States |
Other Details:
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Languages: eng Pagination: 1512-7 Citation Subset: IM |
Affiliation:
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Wesley Long Community Hospital, Greensboro, NC 27403, USA. randy.absher@mosescone.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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African Continental Ancestry Group Age Factors Aged Anticoagulants / administration & dosage*, therapeutic use Body Weight Dose-Response Relationship, Drug European Continental Ancestry Group Female Humans Male Middle Aged Models, Biological Multivariate Analysis Sex Factors Vitamin K / administration & dosage Warfarin / administration & dosage*, therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants; 12001-79-5/Vitamin K; 81-81-2/Warfarin |
| Comments/Corrections | |
Comment In:
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Ann Pharmacother. 2003 Mar;37(3):454; author reply 454
[PMID:
12639185
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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