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• W2078921364 abstract "The primary aim of this study was to analyze the quality of oral anticoagulation management in the real-life practice of hospital geriatric departments, in the absence of a formal dose-adjustment protocol. The secondary objective was to identify factors associated with international normalized ratios (INR) outside the target range.This prospective study was conducted between November 2004 and August 2005 in our hospital's acute geriatric care and geriatric rehabilitation units. It included 110 subjects older than 65 years, all taking fluindione (target INR range of 2 to 3). Indications for oral anticoagulation were atrial fibrillation, venous thromboembolism, and pulmonary embolism. Patients were eligible for inclusion if they had at least 4 INR measurements, and we assessed a maximum of 20 such measures per patient.The study included 74 patients in the acute geriatric unit and 36 subjects in rehabilitation units (mean age: 85 years [65-97 years]), who had 1079 INR tests during the study period (mean per patient: 9.8 (+/-5.5)). Overall, 333 patients (31%) were in the target range of 2-3, 48% below 2, 21% above 3, and 3.6% above 5. The time interval between INR tests did not vary when INR was below 2, but we noted a nonsignificant trend towards a reduction in the average testing interval when INR was above 3 (p=0.079). No bleeding or thrombotic complications were reported during the study. Of the 11 predefined variables, only cancer (history or current) was significantly associated with elevated INR.This study confirms the difficulty of controlling INR in anticoagulation therapy of elderly subjects. Only 31% of tests showed INR in the target range of 2 to 3, a rate lower than in other cohorts. These results may be explained by the high rate of comorbidities in this very old study population." @default.
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• W2078921364 date "2008-12-01" @default.
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• W2078921364 title "Difficultés pour équilibrer les antivitamines K chez des personnes très âgées hospitalisées : étude prospective chez 110 patients avec recherche de facteurs de risque de déséquilibre" @default.
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• W2078921364 doi "https://doi.org/10.1016/j.lpm.2008.04.005" @default.
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