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פותח על ידי קלירמאש פתרונות בע"מ -
Potential dosing errors using portable prothrombin time monitoring devices
Year:
2003
Source of publication :
Blood Coagulation and Fibrinolysis
Authors :
עזרא, דוד
;
.
Volume :
14
Co-Authors:
Loebstein, R., Inst. of Clin. Pharmacol./Toxicology, Anticoagulation Clinic, Chaim Sheba Medical Center, Tel Hashomer, Israel
Kurnik, D., Inst. of Clin. Pharmacol./Toxicology, Anticoagulation Clinic, Chaim Sheba Medical Center, Tel Hashomer, Israel
Lubetsky, A., Inst. of Clin. Pharmacol./Toxicology, Anticoagulation Clinic, Chaim Sheba Medical Center, Tel Hashomer, Israel
Ezra, D., Inst. of Clin. Pharmacol./Toxicology, Anticoagulation Clinic, Chaim Sheba Medical Center, Tel Hashomer, Israel
Halkin, H., Inst. of Clin. Pharmacol./Toxicology, Anticoagulation Clinic, Chaim Sheba Medical Center, Tel Hashomer, Israel, Inst. of Clin. Pharmacol./Toxicology, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel
Facilitators :
From page:
479
To page:
483
(
Total pages:
5
)
Abstract:
Portable prothrombin time (PT) monitors facilitate the control of warfarin therapy. Few studies have compared the influence of using different monitors on dosage decisions. We determined the comparability of data generated by two portable PT monitors, Coaguchek S, (Roche Diagnostics Boehringer-Mannheim) and Hemochron Jr (International Technidyne Corporation Ltd.), with that of a reference laboratory. Simultaneous International Normalized Ratio (INR) measurements (portable monitor and laboratory) were performed in 193 consecutive patients receiving warfarin for at least 3 months. Agreement of measurements was assessed by both regression analysis and influence on dosage decisions in accordance with pre-defined criteria. The Coaguchek S versus laboratory INR regression line (n = 111; r2 = 0.88; P < 0.001) was close to the line of identity, while that of the Hemochron Jr (n = 82; r2 = 0.61; P < 0.001) was not. The overall proportion of dual INR measurements that fulfilled the clinical criteria of agreement was 90% for the Coaguchek S compared with 62% for the Hemochron Jr (P < 0.0001). For laboratory INRs 2.0-2.5, 2.6-4.0 and > 4.0, the proportions of portable measurements that satisfied the clinical criteria for the Coaguchek S versus the Hemochron Jr were 96 versus 63% (P < 0.001), 81 versus 45% (P < 0.04), and 67 versus 17% (P < 0.85), respectively. Warfarin dosing based solely on the portable devices would have resulted in unjustified dose increments in 22% of the patients with the Hemochron Jr device compared with 8% with the Coaguchek S monitor (χ2 = 4.43; P = 0.035). The Coaguchek S monitor provides measurements for INR values within the therapeutic range that agree well with the standard laboratory. The Hemochron Jr measurements result in different dosage adjustments even within the therapeutic range, but especially for INR values > 4.0. For both monitors, agreement of INR measurements with the standard decreases with increasing INR values. © 2003 Lippincott Williams & Wilkins.
Note:
Related Files :
adult
anticoagulation
Female
International Normalized Ratio
Male
Portable prothrombin time monitors
Reproducibility of Results
עוד תגיות
תוכן קשור
More details
DOI :
10.1097/00001721-200307000-00008
Article number:
Affiliations:
Database:
סקופוס
Publication Type:
מאמר
;
.
Language:
אנגלית
Editors' remarks:
ID:
22495
Last updated date:
02/03/2022 17:27
Creation date:
16/04/2018 23:52
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Scientific Publication
Potential dosing errors using portable prothrombin time monitoring devices
14
Loebstein, R., Inst. of Clin. Pharmacol./Toxicology, Anticoagulation Clinic, Chaim Sheba Medical Center, Tel Hashomer, Israel
Kurnik, D., Inst. of Clin. Pharmacol./Toxicology, Anticoagulation Clinic, Chaim Sheba Medical Center, Tel Hashomer, Israel
Lubetsky, A., Inst. of Clin. Pharmacol./Toxicology, Anticoagulation Clinic, Chaim Sheba Medical Center, Tel Hashomer, Israel
Ezra, D., Inst. of Clin. Pharmacol./Toxicology, Anticoagulation Clinic, Chaim Sheba Medical Center, Tel Hashomer, Israel
Halkin, H., Inst. of Clin. Pharmacol./Toxicology, Anticoagulation Clinic, Chaim Sheba Medical Center, Tel Hashomer, Israel, Inst. of Clin. Pharmacol./Toxicology, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel
Potential dosing errors using portable prothrombin time monitoring devices
Portable prothrombin time (PT) monitors facilitate the control of warfarin therapy. Few studies have compared the influence of using different monitors on dosage decisions. We determined the comparability of data generated by two portable PT monitors, Coaguchek S, (Roche Diagnostics Boehringer-Mannheim) and Hemochron Jr (International Technidyne Corporation Ltd.), with that of a reference laboratory. Simultaneous International Normalized Ratio (INR) measurements (portable monitor and laboratory) were performed in 193 consecutive patients receiving warfarin for at least 3 months. Agreement of measurements was assessed by both regression analysis and influence on dosage decisions in accordance with pre-defined criteria. The Coaguchek S versus laboratory INR regression line (n = 111; r2 = 0.88; P < 0.001) was close to the line of identity, while that of the Hemochron Jr (n = 82; r2 = 0.61; P < 0.001) was not. The overall proportion of dual INR measurements that fulfilled the clinical criteria of agreement was 90% for the Coaguchek S compared with 62% for the Hemochron Jr (P < 0.0001). For laboratory INRs 2.0-2.5, 2.6-4.0 and > 4.0, the proportions of portable measurements that satisfied the clinical criteria for the Coaguchek S versus the Hemochron Jr were 96 versus 63% (P < 0.001), 81 versus 45% (P < 0.04), and 67 versus 17% (P < 0.85), respectively. Warfarin dosing based solely on the portable devices would have resulted in unjustified dose increments in 22% of the patients with the Hemochron Jr device compared with 8% with the Coaguchek S monitor (χ2 = 4.43; P = 0.035). The Coaguchek S monitor provides measurements for INR values within the therapeutic range that agree well with the standard laboratory. The Hemochron Jr measurements result in different dosage adjustments even within the therapeutic range, but especially for INR values > 4.0. For both monitors, agreement of INR measurements with the standard decreases with increasing INR values. © 2003 Lippincott Williams & Wilkins.
Scientific Publication
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