Warfarin anticoagulation after congenital heart surgery at a large children's hospital.

Pediatric Cardiology
Adam W LowryJarrod D Knudson

Abstract

Management of warfarin in pediatric patients remains a clinical challenge. Warfarin may be administered after congenital heart surgery, and the risks of morbidity can be high. Currently, no data exist to describe the initiation of warfarin and the risk factors for morbidity in post-congenital heart surgery patients. This study aimed to characterize the time required to reach anticoagulation for patients administered warfarin therapy after cardiac surgery and to identify and characterize the risk factors for supratherapeutic anticoagulation and adverse events after warfarin initiation. This retrospective study reviewed all patients between 2006 and 2011 who received warfarin anticoagulation after cardiac surgery at our institution. Factors associated with a prolonged time required to reach an international normalized ratio (INR) of 2 and factors related to supratherapeutic anticoagulation (INR ≥ 4) were identified. The inclusion criteria were met by 59 patients. The median time required to reach an INR of at least 2 after initiation of warfarin was 2 days (interquartile range (IQR), 2-4). The only groups that required a significantly longer time to reach an INR of 2 were those with a postoperative delay in initiation of warfarin...Continue Reading

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Citations

May 27, 2014·Pediatric Radiology·Anthony J SchaefferCaleb P Nelson
Aug 6, 2015·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Yasemin Kaya, Alper Sindel
Apr 23, 2013·Pediatric Blood & Cancer·Brady S MoffettLisa R Bomgaars
Sep 24, 2014·Congenital Heart Disease·Christopher A ThomasAlexandre T Rotta
May 30, 2020·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Maura HarkinPeter N Johnson
Apr 20, 2021·Cardiology in the Young·Elizabeth J ThompsonChristoph P Hornik

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