Achieving target antifactor Xa activity with a heparin protocol based on sex, age, height, and weight.
OBJECTIVE
To develop and validate an improved unfractionated heparin (UFH) dosage protocol, using antifactor Xa levels as the outcome variable.


METHODS
Prospective case series.


METHODS
A 625-bed, adults-only private, tertiary care teaching hospital.


METHODS
Three hundred seventy-two patients receiving UFH for eight different indications were in the protocol derivation group. One hundred ninety-seven patients were in the final validation group. Intervention. Variables that predicted successful UFH treatment were determined by analysis of variance and regression.


RESULTS
Sex, age, height, weight, UFH dosage, and antifactor Xa levels were variables. A regression model using sex, age, height, and weight was superior to a weight-only model in predicting UFH dosage. Target-range antifactor Xa levels were achieved with the new protocol in 122 (87%) of 140 patients within 24 hours of start of therapy.


CONCLUSIONS
A UFH dosage protocol based on patient sex, age, height, and weight produced improved initial target antifactor Xa levels compared with a weight-based protocol. The protocol is computerized and easy to apply.
Rosborough
Terry K
TK
Medical Education Department, Abbott Northwestern Hospital, Minneapolis, Minnesota 55407, USA.
Shepherd
Michele F
MF
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage* / Q000097:blood; D001827:Body Height; D001835:Body Weight; D002985:Clinical Protocols; D016903:Drug Monitoring / Q000379:methods / Q000592:standards*; D065427:Factor Xa Inhibitors; D005260:Female; D006493:Heparin / Q000008:administration & dosage* / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D011446:Prospective Studies; D012737:Sex Factors
D000925:Anticoagulants; D065427:Factor Xa Inhibitors; D006493:Heparin