Prospective assessment of a nomogram for the initiation of oral anticoagulation therapy for outpatient treatment of venous thromboembolism.
Venous thromboembolism is a common medical problem. Recently, the emphasis has been on a switch to outpatient low molecular weight heparin therapy. Previous warfarin nomograms have been developed only for inpatients. We prospectively assessed a warfarin initiation nomogram in 105 consecutive outpatients; the nomogram requires International Normalized Ratio (INR) testing on only days 3, 5, and 8. Eighty-three percent had a therapeutic INR by day 5 and 98% by day 8. There were no major bleeds and only 6 instances of INR >4.5. This outpatient warfarin nomogram appears to be safe and efficacious in obtaining timely therapeutic levels of warfarin and deserves further study.
Kovacs
M J
MJ
Department of Medicine, London Health Sciences Centre, London, Ontario, Canada. michael.kovacs@lhsc.on.ca
Anderson
D A
DA
Wells
P S
PS
D000328:Adult; D000465:Algorithms; D000553:Ambulatory Care; D000925:Anticoagulants / Q000008:administration & dosage* / Q000627:therapeutic use; D004334:Drug Administration Schedule; D006784:Hospitals, Teaching; D006801:Humans; D019934:International Normalized Ratio; D011446:Prospective Studies; D012449:Safety; D013923:Thromboembolism / Q000188:drug therapy*; D020246:Venous Thrombosis / Q000188:drug therapy*; D014859:Warfarin / Q000008:administration & dosage* / Q000627:therapeutic use
D000925:Anticoagulants; D014859:Warfarin