Predicting international normalised ratio ≥ 4.5 in hospitalised patients using vitamin K antagonists
Vitamin K antagonists (VKAs) used for the prevention and treatment of thromboembolic disease, increase the risk of bleeding complications. This model was developed and validated to predict the risk of an international normalised ratio (INR) ≥4.5 during a hospital stay.

We developed and validated a clinical prediction model for an INR ≥4.5 in VKA-treated patients admitted to our hospital. The model includes factors that are collected during routine care and are extractable from electronic patient records, enabling easy use of this model to predict an increased bleeding
risk in clinical practice.
Research authors: Albert R. Dreijer, Joseph S. Biedermann, Jeroen Diepstraten, Anouk D. Lindemans, Marieke J.H.A. Kruip, Patricia M.L.A. van den Bemt, Yvonne Vergouwe
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Predicted risk of INR ≥ 4.5

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The prediction model can help physicians to identify patients at the lower spectrum of thromboembolic risk and those for whom the risk of bleeding during vitamin K antagonist (VKA) therapy is high. Using the prediction model may also help
when counselling and informing patients about their potential risk for haemorrhage while on anticoagulants, and in identifying those patients who might benefit from more careful management of anticoagulation. Alternatively, these patients can also be switched to direct oral anticoagulants (DOACs), which cause less major bleeding, such as intracranial haemorrhages, compared to VKAs

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Calculations alone should never dictate patient care, and are no substitute for professional judgement. See our full disclaimer.

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