The impact of acute diarrhea on the coagulation status of patients with vitamin K antagonists

Abstract Acute diarrhea is associated with a reduced absorption of both vitamin K antagonists (VKA) and vitamin K itself. To date, the net effect on the coagulation status of subjects with VKA remains elusive. We performed a systematic retrospective single-center analysis using an electronic data ex...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Johannes Schweinfurth, Alexander Bauer, Frederic Bauer, Felix Sebastian Seibert, Benjamin Rohn, Maximilian Seidel, Sebastian Bertram, Ulrik Stervbo, Nina Babel, Timm Henning Westhoff
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/d53271a1551d4b7097a455c1797549f4
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:d53271a1551d4b7097a455c1797549f4
record_format	dspace
spelling	oai:doaj.org-article:d53271a1551d4b7097a455c1797549f42021-12-02T18:25:05ZThe impact of acute diarrhea on the coagulation status of patients with vitamin K antagonists10.1038/s41598-021-91316-x2045-2322https://doaj.org/article/d53271a1551d4b7097a455c1797549f42021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-91316-xhttps://doaj.org/toc/2045-2322Abstract Acute diarrhea is associated with a reduced absorption of both vitamin K antagonists (VKA) and vitamin K itself. To date, the net effect on the coagulation status of subjects with VKA remains elusive. We performed a systematic retrospective single-center analysis using an electronic data extraction approach to identify subjects with plasmatic anticoagulation (either VKA or direct oral anticoagulant (DOAC)) and diarrhea in a German University Hospital over a period of eight years. Acute diarrhea and complete documentation of coagulation status on admission were defined as inclusion criteria, anticoagulation other than VKA/DOAC and obvious inadherence as exclusion criteria. Subjects with VKA/DOAC admitted for hypertension served as control group. Data extraction yielded 356 subjects with gastrointestinal diagnoses and 198 hypertensive subjects, 55 and 83 of whom fulfilled all in- and exclusion criteria. INR values of subjects with VKA were significantly higher in subjects with diarrhea than in hypertensive controls (4.3 ± 3.7 vs. 2.3 ± 0.7, p < 0.001). The distribution of subjects having INR values lower, higher or within the target range differed significantly among groups with a substantially higher prevalence of overanticoagulation in the diarrhea group (46.4% vs. 14.3%, p < 0.001). In a multinomial logistic regression model, acute diarrhea was significantly associated with overanticoagulation (odds ratio 7.2, 95% confidence interval 2.163–23.921; p < 0.001), whereas age, sex, creatinine, and indication of anticoagulation were not (p > 0.05 each). Acute diarrhea is associated with a highly increased risk for overanticoagulation in patients with VKA. Thus, gastroenteritis necessitates a close monitoring of INR in order to identify subjects needing a temporary pause of VKA therapy.Johannes SchweinfurthAlexander BauerFrederic BauerFelix Sebastian SeibertBenjamin RohnMaximilian SeidelSebastian BertramUlrik StervboNina BabelTimm Henning WesthoffNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Johannes Schweinfurth Alexander Bauer Frederic Bauer Felix Sebastian Seibert Benjamin Rohn Maximilian Seidel Sebastian Bertram Ulrik Stervbo Nina Babel Timm Henning Westhoff The impact of acute diarrhea on the coagulation status of patients with vitamin K antagonists
description	Abstract Acute diarrhea is associated with a reduced absorption of both vitamin K antagonists (VKA) and vitamin K itself. To date, the net effect on the coagulation status of subjects with VKA remains elusive. We performed a systematic retrospective single-center analysis using an electronic data extraction approach to identify subjects with plasmatic anticoagulation (either VKA or direct oral anticoagulant (DOAC)) and diarrhea in a German University Hospital over a period of eight years. Acute diarrhea and complete documentation of coagulation status on admission were defined as inclusion criteria, anticoagulation other than VKA/DOAC and obvious inadherence as exclusion criteria. Subjects with VKA/DOAC admitted for hypertension served as control group. Data extraction yielded 356 subjects with gastrointestinal diagnoses and 198 hypertensive subjects, 55 and 83 of whom fulfilled all in- and exclusion criteria. INR values of subjects with VKA were significantly higher in subjects with diarrhea than in hypertensive controls (4.3 ± 3.7 vs. 2.3 ± 0.7, p < 0.001). The distribution of subjects having INR values lower, higher or within the target range differed significantly among groups with a substantially higher prevalence of overanticoagulation in the diarrhea group (46.4% vs. 14.3%, p < 0.001). In a multinomial logistic regression model, acute diarrhea was significantly associated with overanticoagulation (odds ratio 7.2, 95% confidence interval 2.163–23.921; p < 0.001), whereas age, sex, creatinine, and indication of anticoagulation were not (p > 0.05 each). Acute diarrhea is associated with a highly increased risk for overanticoagulation in patients with VKA. Thus, gastroenteritis necessitates a close monitoring of INR in order to identify subjects needing a temporary pause of VKA therapy.
format	article
author	Johannes Schweinfurth Alexander Bauer Frederic Bauer Felix Sebastian Seibert Benjamin Rohn Maximilian Seidel Sebastian Bertram Ulrik Stervbo Nina Babel Timm Henning Westhoff
author_facet	Johannes Schweinfurth Alexander Bauer Frederic Bauer Felix Sebastian Seibert Benjamin Rohn Maximilian Seidel Sebastian Bertram Ulrik Stervbo Nina Babel Timm Henning Westhoff
author_sort	Johannes Schweinfurth
title	The impact of acute diarrhea on the coagulation status of patients with vitamin K antagonists
title_short	The impact of acute diarrhea on the coagulation status of patients with vitamin K antagonists
title_full	The impact of acute diarrhea on the coagulation status of patients with vitamin K antagonists
title_fullStr	The impact of acute diarrhea on the coagulation status of patients with vitamin K antagonists
title_full_unstemmed	The impact of acute diarrhea on the coagulation status of patients with vitamin K antagonists
title_sort	impact of acute diarrhea on the coagulation status of patients with vitamin k antagonists
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/d53271a1551d4b7097a455c1797549f4
work_keys_str_mv	AT johannesschweinfurth theimpactofacutediarrheaonthecoagulationstatusofpatientswithvitaminkantagonists AT alexanderbauer theimpactofacutediarrheaonthecoagulationstatusofpatientswithvitaminkantagonists AT fredericbauer theimpactofacutediarrheaonthecoagulationstatusofpatientswithvitaminkantagonists AT felixsebastianseibert theimpactofacutediarrheaonthecoagulationstatusofpatientswithvitaminkantagonists AT benjaminrohn theimpactofacutediarrheaonthecoagulationstatusofpatientswithvitaminkantagonists AT maximilianseidel theimpactofacutediarrheaonthecoagulationstatusofpatientswithvitaminkantagonists AT sebastianbertram theimpactofacutediarrheaonthecoagulationstatusofpatientswithvitaminkantagonists AT ulrikstervbo theimpactofacutediarrheaonthecoagulationstatusofpatientswithvitaminkantagonists AT ninababel theimpactofacutediarrheaonthecoagulationstatusofpatientswithvitaminkantagonists AT timmhenningwesthoff theimpactofacutediarrheaonthecoagulationstatusofpatientswithvitaminkantagonists AT johannesschweinfurth impactofacutediarrheaonthecoagulationstatusofpatientswithvitaminkantagonists AT alexanderbauer impactofacutediarrheaonthecoagulationstatusofpatientswithvitaminkantagonists AT fredericbauer impactofacutediarrheaonthecoagulationstatusofpatientswithvitaminkantagonists AT felixsebastianseibert impactofacutediarrheaonthecoagulationstatusofpatientswithvitaminkantagonists AT benjaminrohn impactofacutediarrheaonthecoagulationstatusofpatientswithvitaminkantagonists AT maximilianseidel impactofacutediarrheaonthecoagulationstatusofpatientswithvitaminkantagonists AT sebastianbertram impactofacutediarrheaonthecoagulationstatusofpatientswithvitaminkantagonists AT ulrikstervbo impactofacutediarrheaonthecoagulationstatusofpatientswithvitaminkantagonists AT ninababel impactofacutediarrheaonthecoagulationstatusofpatientswithvitaminkantagonists AT timmhenningwesthoff impactofacutediarrheaonthecoagulationstatusofpatientswithvitaminkantagonists
_version_	1718378064905240576

The impact of acute diarrhea on the coagulation status of patients with vitamin K antagonists

Ejemplares similares