The Effect of Preoperative Vitamin K on the INR in Bridging Therapy

Ashrei Bayewitz; Barbara Scorziello; Clarice Maala; Emily Giannattasio; Henny Heisler Billett

doi:10.1007/s12185-015-1744-x

The Effect of Preoperative Vitamin K on the INR in Bridging Therapy

Ashrei Bayewitz, Barbara Scorziello, Clarice Maala, Emily Giannattasio, Henny Heisler Billett

Oncology

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

We investigated a bridging protocol using oral Vitamin K three days before scheduled surgery. 60 patients in two bridging protocols, 30 cases per protocol. The first cohort (Control group) had its warfarin held on Day-5 (five days before surgery). The intervention cohort (Vitamin K group) routinely received 2.5 mg of oral Vitamin K on Day-3 but was otherwise identically bridged. Primary outcome was INR on Day-1. Secondary outcomes included patients with INRs ≥1.5 on Day-1, bleeding episodes and elevated INR post surgery. Day-1 INR for the Vitamin K group was 1.16, vs. 1.28 for the Control group (p = 0.037). Postoperative INR was similar. Only the Control group had patients with INRs ≥1.5 on Day-1, or patients with significant bleeding. Adding Vitamin K on Day-3 leads to a safe preoperative INR and may limit other complications.

Original language	English (US)
Pages (from-to)	264-267
Number of pages	4
Journal	International journal of hematology
Volume	101
Issue number	3
DOIs	https://doi.org/10.1007/s12185-015-1744-x
State	Published - Mar 6 2015

Keywords

Anticoagulation
Bridging therapy
Vitamin K

ASJC Scopus subject areas

Hematology

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10.1007/s12185-015-1744-x

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title = "The Effect of Preoperative Vitamin K on the INR in Bridging Therapy",

abstract = "We investigated a bridging protocol using oral Vitamin K three days before scheduled surgery. 60 patients in two bridging protocols, 30 cases per protocol. The first cohort (Control group) had its warfarin held on Day-5 (five days before surgery). The intervention cohort (Vitamin K group) routinely received 2.5 mg of oral Vitamin K on Day-3 but was otherwise identically bridged. Primary outcome was INR on Day-1. Secondary outcomes included patients with INRs ≥1.5 on Day-1, bleeding episodes and elevated INR post surgery. Day-1 INR for the Vitamin K group was 1.16, vs. 1.28 for the Control group (p = 0.037). Postoperative INR was similar. Only the Control group had patients with INRs ≥1.5 on Day-1, or patients with significant bleeding. Adding Vitamin K on Day-3 leads to a safe preoperative INR and may limit other complications.",

keywords = "Anticoagulation, Bridging therapy, Vitamin K",

author = "Ashrei Bayewitz and Barbara Scorziello and Clarice Maala and Emily Giannattasio and Billett, {Henny Heisler}",

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AU - Scorziello, Barbara

AU - Maala, Clarice

AU - Giannattasio, Emily

AU - Billett, Henny Heisler

PY - 2015/3/6

Y1 - 2015/3/6

N2 - We investigated a bridging protocol using oral Vitamin K three days before scheduled surgery. 60 patients in two bridging protocols, 30 cases per protocol. The first cohort (Control group) had its warfarin held on Day-5 (five days before surgery). The intervention cohort (Vitamin K group) routinely received 2.5 mg of oral Vitamin K on Day-3 but was otherwise identically bridged. Primary outcome was INR on Day-1. Secondary outcomes included patients with INRs ≥1.5 on Day-1, bleeding episodes and elevated INR post surgery. Day-1 INR for the Vitamin K group was 1.16, vs. 1.28 for the Control group (p = 0.037). Postoperative INR was similar. Only the Control group had patients with INRs ≥1.5 on Day-1, or patients with significant bleeding. Adding Vitamin K on Day-3 leads to a safe preoperative INR and may limit other complications.

AB - We investigated a bridging protocol using oral Vitamin K three days before scheduled surgery. 60 patients in two bridging protocols, 30 cases per protocol. The first cohort (Control group) had its warfarin held on Day-5 (five days before surgery). The intervention cohort (Vitamin K group) routinely received 2.5 mg of oral Vitamin K on Day-3 but was otherwise identically bridged. Primary outcome was INR on Day-1. Secondary outcomes included patients with INRs ≥1.5 on Day-1, bleeding episodes and elevated INR post surgery. Day-1 INR for the Vitamin K group was 1.16, vs. 1.28 for the Control group (p = 0.037). Postoperative INR was similar. Only the Control group had patients with INRs ≥1.5 on Day-1, or patients with significant bleeding. Adding Vitamin K on Day-3 leads to a safe preoperative INR and may limit other complications.

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KW - Bridging therapy

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The Effect of Preoperative Vitamin K on the INR in Bridging Therapy

Abstract

Keywords

ASJC Scopus subject areas

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