Open AccessProspective Assessment of a Nomogram for the Initiation of Oral Anticoagulation Therapy for Outpatient Treatment of Venous Thromboembolism
Author(s) -
Michael J. Kovacs,
David Anderson,
Philip S. Wells
Publication year - 2002
Publication title -
pathophysiology of haemostasis and thrombosis
Language(s) - English
Resource type - Journals
eISSN - 1424-8840
pISSN - 1424-8832
DOI - 10.1159/000065215
Subject(s) - nomogram , medicine , warfarin , venous thromboembolism , heparin , prospective cohort study , outpatient clinic , intensive care medicine , surgery , thrombosis , atrial fibrillation
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.