Trial reportAnnals of the Royal College of Surgeons of England2010
An audit of the role of vitamin K in the reversal of International Normalised Ratio (INR) in patients undergoing surgery for hip fracture.
Trial report in Annals of the Royal College of Surgeons of England, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Safety of expedited-surgery protocols in anticoagulant-treated patients with hip fracture: a systematic review and meta-analysis.Canadian journal of surgery. Journal canadien de chirurgiePooled it
- Propensity matched analysis examining the effect of passive reversal of direct oral anticoagulants on blood loss and the need for transfusions among traumatic geriatric hip fractures.European journal of medical research · 2023Article
- The Effect of Pre-operative use of Antiplatelets and Anticoagulants on Time to Surgery in Hip Fracture Patients.Malaysian orthopaedic journal · 2023Article
- The Perioperative Management of Antiplatelet and Anticoagulant Drugs in Hip Fractures: Do the Surgery as Early as Possible.The archives of bone and joint surgery · 2022Review
- Semi-empirical anticoagulation model (SAM): INR monitoring during Warfarin therapy.Journal of pharmacokinetics and pharmacodynamics · 2022Article
- Partial warfarin reversal prior to hip fracture surgical intervention in geriatric trauma patients effects on blood loss and transfusions.Journal of clinical orthopaedics and trauma · 2021Article
- Postoperative Complications of Hip Fractures Patients on Chronic Coumadin: A Comparison Based on Operative International Normalized Ratio.Geriatrics (Basel, Switzerland) · 2020Article
- Is anticoagulation reversal necessary prior to surgical treatment of geriatric hip fractures?Journal of clinical orthopaedics and trauma · 2020Article
- The impact of warfarin on operative delay and 1-year mortality in elderly patients with hip fracture: a retrospective observational study.Journal of orthopaedic surgery and research · 2019Observational
- Is fast reversal and early surgery (within 24 h) in patients on warfarin medication with trochanteric hip fractures safe? A case-control study.BMC musculoskeletal disorders · 2018Article
- Management of anticoagulation in hip fractures: A pragmatic approach.EFORT open reviews · 2017Article
- "Early Trigger" Intravenous Vitamin K: Optimizing Target-Driven Care in Warfarinised Patients With Hip Fracture.Geriatric orthopaedic surgery & rehabilitation · 2015Article
- "Tiers of delay": warfarin, hip fractures, and target-driven care.Geriatric orthopaedic surgery & rehabilitation · 2014Article
- An evidence-based warfarin management protocol reduces surgical delay in hip fracture patients.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2014Observational
- Algorithm for anticoagulation management in geriatric hip fracture patients--Surgeons save Blood.Zeitschrift fur Gerontologie und Geriatrie · 2014Review
- Appropriateness of Using Vitamin K for the Correction of INR Elevation Secondary to Hepatic Disease in Critically ill Patients: An Observational Study.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisObservational
- Clinical protocols for oral anticoagulant reversal during high risk of bleeding for emergency surgical and nonsurgical settings: a narrative review.Brazilian journal of anesthesiology (Elsevier)Review
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe objective of this prospective audit was to compare two methods of anticoagulation reversal in the pre-operative period for hip fracture patients. PATIENTS AND
methodsIn the first part of the audit, our current practice was analysed. Data relating to the number of days from admission to surgery and the reasons for delay to surgery were collected. Also, data concerning common reasons for which the patients were started on warfarin and the time required for INR to drop to 1.5 or below were collected. In the second part of the audit, 45 patients with INR above 1.5 were given a single dose of vitamin K (1 mg i.v.) in addition to stopping warfarin.
resultsThe mean difference in the time for INR < 1.5 in the two groups was 2 days (52 h; P < 0.05). The mean difference in wait for surgery since admission between the two groups was 4 days (91 h; P < 0.05). There was no significant difference between the two groups as regards the average number of co-morbidities in the patient groups.
conclusionsA single 1 mg intravenous dose of vitamin K significantly reduces the time for the reversal of INR and the pre-operative delay to surgery, in patients on long-term warfarin. We conclude that 1 mg of intravenous vitamin K on admission is a safe and effective treatment to avoid delay in the treatment in this group of patients.
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