another study of adverse events

[warrenr]

This study was conducted at The McConnell Health and Heart center in Columbus ohio. It seems like they left out a lot of important facts.


6. Relationship between INR and adverse events in patients treated at an anticoagulation clinic.

Snow R, LaLonde M, Hindman L, Knoell K, Jennings M, Hyek M, Caulin-Glaser T.

Summary: The therapeutic window for reduction of stroke risk using warfarin in patients with atrial fibrillation has been defined as an INR of 2.0 to 3.0. We examined the INR in patients treated in a systematic manner at our anticoagulation clinic with atrial fibrillation as the only indication and admitted to a hospital with thromboembolic or hemorrhagic events. Event rates were 39 per 1000pt/yr combined, 26 per 1000pt/yr hemorrhagic and 13 per 1000pt/yr thromboembolic. The rates of normal or subtheraputic INR on admission in hemorrhagic events requiring hospitalization was 38% and normal INR on admission for thromboembolic events requiring hospitalization was 25%. Overall, 33% of patients having events had INR within the therapeutic window, or low INR in hemorrhagic events, at the time of their event. Our results demonstrate that one third of patients managed in a systematic manner will have events unrelated to poorly managed anticoagulation. AHA 5 th Annual Forum on Qual, April 2004

Is this confusing to all of you as it is to me. They state that

"Our results demonstrate that one third of patients managed in a systematic manner will have events unrelated to poorly managed anticoagulation".

Does this mean that two thirds of the poorly managed will have adverse events????

Unless I am missing something, it seems that they are trying to say a lot without really saying anything.

 

[jeffp]

Hey Warren, do you have link to where you found the info, I'd be interested in the full article?
What I think they were trying to say, or said, was that 1/3 of the people who had events, had INR within range at the time of the event. That's why I'd like to see more of the study to see if they have data on the whole atrial fribrillation population, or just those that presented with an event.
I'm working on my master's thesis on effectiveness of INR control in atrial fibrillation patients to reduce stroke, and this seems like an appropriate study.

 

[warrenr]

study

study

Jeff,

Here is the link
http://www.ohiohealth.com/bodymcconnell.cfm?id=1495

can't find anything other than the summary. Maybe if you call them they can provide you with more info.

Are you familiar with the stroke study that Dr. Cohen conducted on afib patients with subtherepeutic INR's? If not, let me know and I will send you the info.

 

[tobagotwo]

Wow. Pass me that grammar primer. Why is is so difficult for people to edit, read, and edit again?

My interpretation of What He Meant To Say is that...

Out of all the Afib patients on Coumadin in his clinic who had a stroke or bleeding in the brain, two thirds had INRs out of the proper range. One third had the attack despite being in the proper INR range.

Best wishes,

 

[warrenr]

a

a

that's how I see it.