JAMA:接受髋关节或膝关节置换术老年患者华法林INR应为1.8

2019-09-04 MedSci MedSci原创

在接受髋关节或膝关节置换术并接受华法林预防治疗的老年患者中,国际标准化比率目标应为1.8,而不是2.5

在华法林治疗的近期关节置换术患者中,预防静脉血栓栓塞(VTE)的最佳国际标准化比率(INR)尚不清楚。近日研究人员考察了骨科手术后VTE预防的目标INR为1.8 vs 2.5的安全性和有效性差异。

1650名65岁或65岁以上,进行选择性髋关节或膝关节置换术患者参与研究。随机分为目标INR为1.8(n=823)或2.5(n=827)。研究的主要结果为VTE(60天内)或死亡(30天内)。,次要终点为出血,INR值为4或以上。

患者平均年龄72.1岁,1049名妇女,1597名(96.8%)接受了至少1剂华法林治疗。低强度-华法林组(INR目标1.8)和标准治疗-华法林组(INR目标2.5)的VTE和死亡的主要复合结果的比率分别为5.1%(41/804)和3.8%(30/793),差异为1.3%,达到非劣性。低强度组0.4%的患者和标准强度组0.9%的患者出现严重出血,差异为-0.5%。低强度组4.5%的患者和标准强度组12.2%的患者出现4个或更多的INR值,差异为-7.8%。

在接受髋关节或膝关节置换术并接受华法林预防治疗的老年患者中,国际标准化比率目标应为1.8,而不是2.5。

原始出处:


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    2019-11-11 yxch48
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    2019-09-04 一个字-牛

    学习了谢谢分享

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