Appropriateness of Using Vitamin K for the Correction of INR Elevation Secondary to Hepatic Disease in Critically ill Patients: An Observational Study

Background Using vitamin K for correction of coagulopathy in critically ill patients is controversial with limited evidence. This study aims to evaluate the efficacy and safety of vitamin K in the correction of international normalized ratio (INR) elevation secondary to liver disease in critically i...

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Autores principales:	Khalid Al Sulaiman, Mashael Al Mutairi, Omar Al Harbi, Alanoud Al Duraihim, Sara Aldosary, Haifa Al Khalil, Abdulrahman Al Shaya, Shmeylan Al Harbi, Nouf Alotaibi, Kholoud Al Aamer, Ramesh Vishwakarma, Mohammed Al Asiri, Ohoud Aljuhani, Abdulmalik Al Katheri, Abdulkareem M. Al Bekairy
Formato:	article
Lenguaje:	EN
Publicado:	SAGE Publishing 2021
Materias:	Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/0d4647e9cbd54c529725b3bec9aa442a
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spelling	oai:doaj.org-article:0d4647e9cbd54c529725b3bec9aa442a2021-12-02T01:33:19ZAppropriateness of Using Vitamin K for the Correction of INR Elevation Secondary to Hepatic Disease in Critically ill Patients: An Observational Study1938-272310.1177/10760296211050923https://doaj.org/article/0d4647e9cbd54c529725b3bec9aa442a2021-11-01T00:00:00Zhttps://doi.org/10.1177/10760296211050923https://doaj.org/toc/1938-2723Background Using vitamin K for correction of coagulopathy in critically ill patients is controversial with limited evidence. This study aims to evaluate the efficacy and safety of vitamin K in the correction of international normalized ratio (INR) elevation secondary to liver disease in critically ill patients. Method A retrospective study of critically ill patients with coagulopathy secondary to liver disease. The primary outcome was to evaluate the association between vitamin K administration and the incidence of new bleeding events in critically ill patients with INR elevation; other outcomes were considered secondary. Patients were categorized into two groups based on vitamin K administration to correct INR elevation. The propensity score was generated based on disease severity scores and the use of pharmacological DVT prophylaxis. Results A total of 98 patients were included in the study. Forty-seven patients (48%) received vitamin K during the study period. The odds of the new bleeding event was not statistically different between groups (OR 2.4, 95% CI 0.28-21.67, P = .42). Delta of INR reduction was observed with a median of 0.63 when the first dose is given ( P -value: <.0001). However the INR reduction with other subsequent doses of vitamin K was not statistically significant. Conclusion The administration of vitamin K for INR correction in critically ill patients with coagulopathy secondary to liver disease was not associated with a lower odds of new bleeding events. Further studies are needed to assess the value of vitamin K administration in critically ill patients with liver diseases related coagulopathy.Khalid Al SulaimanMashael Al MutairiOmar Al HarbiAlanoud Al DuraihimSara AldosaryHaifa Al KhalilAbdulrahman Al ShayaShmeylan Al HarbiNouf AlotaibiKholoud Al AamerRamesh VishwakarmaMohammed Al AsiriOhoud AljuhaniAbdulmalik Al KatheriAbdulkareem M. Al BekairySAGE PublishingarticleDiseases of the circulatory (Cardiovascular) systemRC666-701ENClinical and Applied Thrombosis/Hemostasis, Vol 27 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Diseases of the circulatory (Cardiovascular) system RC666-701 Khalid Al Sulaiman Mashael Al Mutairi Omar Al Harbi Alanoud Al Duraihim Sara Aldosary Haifa Al Khalil Abdulrahman Al Shaya Shmeylan Al Harbi Nouf Alotaibi Kholoud Al Aamer Ramesh Vishwakarma Mohammed Al Asiri Ohoud Aljuhani Abdulmalik Al Katheri Abdulkareem M. Al Bekairy Appropriateness of Using Vitamin K for the Correction of INR Elevation Secondary to Hepatic Disease in Critically ill Patients: An Observational Study
description	Background Using vitamin K for correction of coagulopathy in critically ill patients is controversial with limited evidence. This study aims to evaluate the efficacy and safety of vitamin K in the correction of international normalized ratio (INR) elevation secondary to liver disease in critically ill patients. Method A retrospective study of critically ill patients with coagulopathy secondary to liver disease. The primary outcome was to evaluate the association between vitamin K administration and the incidence of new bleeding events in critically ill patients with INR elevation; other outcomes were considered secondary. Patients were categorized into two groups based on vitamin K administration to correct INR elevation. The propensity score was generated based on disease severity scores and the use of pharmacological DVT prophylaxis. Results A total of 98 patients were included in the study. Forty-seven patients (48%) received vitamin K during the study period. The odds of the new bleeding event was not statistically different between groups (OR 2.4, 95% CI 0.28-21.67, P = .42). Delta of INR reduction was observed with a median of 0.63 when the first dose is given ( P -value: <.0001). However the INR reduction with other subsequent doses of vitamin K was not statistically significant. Conclusion The administration of vitamin K for INR correction in critically ill patients with coagulopathy secondary to liver disease was not associated with a lower odds of new bleeding events. Further studies are needed to assess the value of vitamin K administration in critically ill patients with liver diseases related coagulopathy.
format	article
author	Khalid Al Sulaiman Mashael Al Mutairi Omar Al Harbi Alanoud Al Duraihim Sara Aldosary Haifa Al Khalil Abdulrahman Al Shaya Shmeylan Al Harbi Nouf Alotaibi Kholoud Al Aamer Ramesh Vishwakarma Mohammed Al Asiri Ohoud Aljuhani Abdulmalik Al Katheri Abdulkareem M. Al Bekairy
author_facet	Khalid Al Sulaiman Mashael Al Mutairi Omar Al Harbi Alanoud Al Duraihim Sara Aldosary Haifa Al Khalil Abdulrahman Al Shaya Shmeylan Al Harbi Nouf Alotaibi Kholoud Al Aamer Ramesh Vishwakarma Mohammed Al Asiri Ohoud Aljuhani Abdulmalik Al Katheri Abdulkareem M. Al Bekairy
author_sort	Khalid Al Sulaiman
title	Appropriateness of Using Vitamin K for the Correction of INR Elevation Secondary to Hepatic Disease in Critically ill Patients: An Observational Study
title_short	Appropriateness of Using Vitamin K for the Correction of INR Elevation Secondary to Hepatic Disease in Critically ill Patients: An Observational Study
title_full	Appropriateness of Using Vitamin K for the Correction of INR Elevation Secondary to Hepatic Disease in Critically ill Patients: An Observational Study
title_fullStr	Appropriateness of Using Vitamin K for the Correction of INR Elevation Secondary to Hepatic Disease in Critically ill Patients: An Observational Study
title_full_unstemmed	Appropriateness of Using Vitamin K for the Correction of INR Elevation Secondary to Hepatic Disease in Critically ill Patients: An Observational Study
title_sort	appropriateness of using vitamin k for the correction of inr elevation secondary to hepatic disease in critically ill patients: an observational study
publisher	SAGE Publishing
publishDate	2021
url	https://doaj.org/article/0d4647e9cbd54c529725b3bec9aa442a
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Appropriateness of Using Vitamin K for the Correction of INR Elevation Secondary to Hepatic Disease in Critically ill Patients: An Observational Study

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