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Effect of Laboratory Variation in the Prothrombin-Time Ratio on the Results of Oral Anticoagulant Therapy
NEJM 329:696-702, Eckman,M.H.,et al, 1993
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Article Abstract
Anticoagulation provides a striking benefit for patients whose treatment is conducted within the recommended range of the international normalized ratio(INR)-i.e.,2.5 to 3.5-but if uncertainty about the laboratory results causes the intensity of anticoagulation to fall outside this range,the gain becomes smaller.Uncertainty about the true intensity of anticoagulation may reduce the potential gain in life expectancy,adjusted for quality of life,by more than half and may increase the ratio of costs to effectiveness to almost five times the optimal value.Variability in the intensity of anticoagulation is even greater if older recommendations advocating a higher level of anticoagulation are followed.
 
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anticoagulant,complications of
anticoagulant,treatment
INR values
laboratory values,normal
prothrombin time

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