지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
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초록· 키워드
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Background: Although thromboembolism is common and one of the major causes of mortality in cancer patients, maintaining therapeutic anticoagulation effect with warfarin is challenging. This study aimed to determine the prevalence and the causes of non-therapeutic INR (International Normalized Ratio) in cancer patients. Methods: Medical and pharmacy records for cancer patients managed by the pharmacist-run anticoagulation service (ACS) between May, 2010 and April, 2011 at Seoul National University Hospital were retrospectively reviewed. The causes of non-therapeutic INR were identified and compared with the results from a former study with mechanical heart valve patients. Results: A total of 335 cancer patients and 6,737 patient-visits were analyzed producing 68% (n=4,590) of non-therapeutic INR readings. Eightyfive percent of the non-therapeutic INR readings were categorized as sub-therapeutic. Frequent causes linked to non-therapeutic INR included inadequate dosage adjustment (21.8%), changes in health status (11.8%), dietary changes (8.1%), and drug interactions (4.2%). More than half of the non-therapeutic INR values had no known etiology. As causes for non-therapeutic INR, changes in health status (p<0.0001), adverse reactions (p<0.0001), and dietary changes (p=0.017) were statistically more frequent in cancer patients than in patients with mechanical heart valves. Furthermore, exposure to sub-therapeutic INR were more prevalent in cancer patients than in patients with mechanical heart valve (p<0.0001). Conclusions: This study shows that there is a tendency to keep the level of INR low and that health status change, dietary change, and drug interactions are found to be frequent causes for non-therapeutic INR in cancer patients.
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참고문헌 (25)
참고문헌 신청
/ / National cancer comprehensive network clinical practice guidelines in oncology: Venous Thromboembolic Disease V.1.2009
/ 2010 / Warfarin-indications, risks and drug
Adamson D. J. A / 1993 / Occult malignancy is associated with venous thrombosis unresponsive to adequate anticoagulation / Br J Clin Pract 47 (4) : 190 ~ 191
Akl EA / 2008 / Thromboprophylaxis for patients with cancer and central venous catheters : a systematic review and a meta-analysis / Cancer 112 (11) : 2483 ~ 2492
Blom JW / 2005 / Malignancies, prothrombotic mutations and the risk of venous thrombosis / JAMA 293 (6) : 715 ~ 722
/ 2010 / Warfarin-indications, risks and drug
Adamson D. J. A / 1993 / Occult malignancy is associated with venous thrombosis unresponsive to adequate anticoagulation / Br J Clin Pract 47 (4) : 190 ~ 191
Akl EA / 2008 / Thromboprophylaxis for patients with cancer and central venous catheters : a systematic review and a meta-analysis / Cancer 112 (11) : 2483 ~ 2492
Blom JW / 2005 / Malignancies, prothrombotic mutations and the risk of venous thrombosis / JAMA 293 (6) : 715 ~ 722
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