Evidence map›Paper›PMID 27777713›Full record

ArticleClinics and practice2016

Medication Error When Switching from Warfarin to Rivaroxaban Leading to Spontaneous Large Ecchymosis of the Abdominal and Chest Wall.

Flavio Egger, Federica Targa, Ivan Unterholzner, Russell P Grant, Markus Herrmann, Christian J Wiedermann

Open access · goldAbstract readCase Reports
In one paragraph

Article in Clinics and practice, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.9field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Trial
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 2 countries.

Flavio EggerDepartment of Internal Medicine, Central Hospital of Bolzano , BZ, Italy.
Federica TargaDepartment of Clinical Pathology, Central Hospital of Bolzano , BZ, Italy.
Ivan UnterholznerDepartment of Internal Medicine, Central Hospital of Bolzano , BZ, Italy.
Russell P GrantCenter for Esoteric Testing, Laboratory Corporation of America® Holdings , Burlington, NC, USA.
Markus HerrmannDepartment of Clinical Pathology, Central Hospital of Bolzano , BZ, Italy.
Christian J WiedermannDepartment of Internal Medicine, Central Hospital of Bolzano , BZ, Italy.
Ospedale di Bolzano · ITLabCorp (United States) · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Non-vitamin K oral anticoagulant (NOAC) therapy may be inappropriate if prescription was incorrect, the patient's physiological parameters change, or interacting concomitant medications are erroneously added. The aim of this report was to illustrate inappropriate NOAC prescription in a 78-year-old woman with non-valvular atrial fibrillation and borderline renal dysfunction who was switched from warfarin to rivaroxaban and subsequently developed bruising with hemorrhagic shock and acute on chronic renal failure. Administration of 4-factor prothrombin complex concentrate effectively reversed coagulopathy and stopped bleeding. Retrospective determination of circulating plasma levels of rivaroxaban and warfarin confirmed that excessive anticoagulation was likely due to warfarin that the patient probably continued to take although rivaroxaban was initiated. Pharmacodynamic interaction between rivaroxaban and warfarin may not only be additive but synergistic. In patients at high risk of complications, judicious prescribing and dosing of NOACs, and regular monitoring of concomitant medications and renal function are highly recommended.

Indexed as

anticoagulant reversalDirect oral anticoagulantsdrug-drug interactiondrug safetypharmacovigilanceprothrombin complex concentratetherapeutic drug monitoring

Identifiers

PMID27777713
PMCPMC5067405
OpenAlexW2508354934

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.