Self-monitoring of oral anticoagulation therapy in children.
This study aimed to investigate the accuracy of home International Normalized Ratio (INR) self-monitoring in pediatric patients on long-term oral anticoagulation therapy. Statistical and clinical agreement of INR values from capillary whole blood samples measured by 2 different portable prothrombin time monitors (CoaguChek S and XS) and venous blood samples measured by a laboratory coagulation analyzer were evaluated using the Bland-Altman analysis. Eighty-three INR comparisons (56 using the CoaguChek S and 27 using the CoaguChek XS) were obtained from 35 children aged 4 months to 18 years. Mean differences between venous and capillary INR values and their limits of agreement were -0.04 (-0.63 to 0.55) overall, 0.006 (-0.63 to 0.65) for the CoaguChek S and -0.13 (-0.57 to 0.31) for the CoaguChek XS. The Pearson correlation coefficients were 0.88 overall, 0.84 for the CoaguChek S and 0.95 for the CoaguChek XS. Expanded and narrow agreements for all patients were 97.6 and 94%, respectively. In conclusion, home INR self-monitoring is accurate for children requiring long-term oral anticoagulation therapy. Our data suggest that INR self-monitoring with the newer CoaguChek XS is more accurate than with the older CoaguChek S monitor.
Paioni
Paolo
P
Divisions of Paediatrics, University Children's Hospital, Zurich, Switzerland.
Kroiss
Sabine
S
Kägi
Elsbeth
E
Bergsträsser
Eva
E
Fasnacht
Margrit
M
Bauersfeld
Urs
U
Schmugge
Markus
M
Albisetti
Manuela
M
D000293:Adolescent; D000925:Anticoagulants / Q000627:therapeutic use*; D002196:Capillaries; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D019934:International Normalized Ratio; D008297:Male; D019095:Point-of-Care Systems; D011517:Prothrombin Time / Q000295:instrumentation* / Q000379:methods; D012648:Self Care / Q000379:methods
D000925:Anticoagulants