Document Detail


Patient-specific factors predictive of warfarin dosage requirements.
MedLine Citation:
PMID:  12243598     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Randall K Absher; M Elisabeth Moore; Mary H Parker
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Annals of pharmacotherapy     Volume:  36     ISSN:  1060-0280     ISO Abbreviation:  Ann Pharmacother     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-09-23     Completed Date:  2003-04-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9203131     Medline TA:  Ann Pharmacother     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1512-7     Citation Subset:  IM    
Affiliation:
Wesley Long Community Hospital, Greensboro, NC 27403, USA. randy.absher@mosescone.com
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MeSH Terms
Descriptor/Qualifier:
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:
0/Anticoagulants; 12001-79-5/Vitamin K; 81-81-2/Warfarin
Comments/Corrections
Comment In:
Ann Pharmacother. 2003 Mar;37(3):454; author reply 454   [PMID:  12639185 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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