A simple formula for predicting the warfarin dose in atrial fibrillation: development, external validation, and model comparison.

IF 2.2 4区医学 Q2 HEMATOLOGY

Thrombosis Journal Pub Date : 2025-10-09 DOI:10.1186/s12959-025-00776-y

Anunya Ujjin, Natnicha Pongbangli, Wanwarang Wongcharoen, Arisara Suwanagool, Chatree Chai-Adisaksopha

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引用次数: 0

Abstract

Background: The dose of warfarin varies between individuals. Several formulas for predicting the maintenance dose of warfarin have been developed; however, most are complicated and not practical for clinical use.

Objective: To determine factors that predict warfarin dosage and the relationship between clinical variables and the maintenance dose of warfarin, and to develop a simple formula for predicting the maintenance dose of warfarin that is particularly useful for identifying patients with atrial fibrillation (AF) who are at higher risk of bleeding, without relying on pharmacogenetic data.

Materials and methods: This was a retrospective cohort study carried out between 2011 and 2021. All patients are started on warfarin with a target INR of 2.0 to 3.0. The prediction models for the maintenance dose were developed using a first-order equation. Correlation and performance of the formula were examined in training and validation cohorts.

Results: A training cohort consisted of 520 patients with a mean age of 69 ± 12 years. The proposed warfarin dosing formula was 3+(0.02×body weight (kg))-(0.02×age (years))-(0.4×serum creatinine (mg/dL)).When compared with a warfarin dosing formula, a 3-mg dose was associated with overdosing with an odds ratio [OR] of 3.31 (95%CI 2.26-4.84, p < 0.0001) in patients whose body weight was < 60 kg, OR 3.08 (95%CI 2.15-4.40, p < 0.0001) in patients aged ≥ 70 years and OR 2.39 (95% CI 1.67-3.44, p < 0.0001) in patients with eGFR < 50 mL/min. The findings in the validation cohort of 632 patients were concordant with the training cohort.

Conclusion: A simple warfarin dosing formula incorporating age, body weight, and serum creatinine reduced the risk of warfarin overdose in a high-risk population.

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预测心房颤动华法林剂量的简单公式：开发、外部验证和模型比较。

背景：华法林的剂量因人而异。目前已有几种预测华法林维持剂量的公式；然而，大多数是复杂的，不适合临床使用。目的：确定预测华法林剂量的因素以及临床变量与华法林维持剂量之间的关系，并建立一个预测华法林维持剂量的简单公式，该公式对于识别出血风险较高的心房颤动（AF）患者特别有用，无需依赖药物遗传学数据。材料和方法：这是一项回顾性队列研究，于2011年至2021年进行。所有患者开始使用华法林，目标INR为2.0至3.0。采用一阶方程建立了维持剂量的预测模型。在训练和验证队列中检验了公式的相关性和性能。结果：训练队列包括520例患者，平均年龄为69±12岁。建议华法林给药公式为3+（0.02×body体重（kg））-（0.02×age（年））-（0.4×serum肌酐（mg/dL））。与华法林剂量公式相比，3mg剂量与过量用药相关，比值比为3.31 （95%CI 2.26-4.84, p）。结论：考虑年龄、体重和血清肌酐的简单华法林剂量公式降低了高危人群华法林过量用药的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Thrombosis Journal Medicine-Hematology

CiteScore

3.80

自引率

3.20%

发文量

审稿时长

16 weeks

期刊介绍： Thrombosis Journal is an open-access journal that publishes original articles on aspects of clinical and basic research, new methodology, case reports and reviews in the areas of thrombosis. Topics of particular interest include the diagnosis of arterial and venous thrombosis, new antithrombotic treatments, new developments in the understanding, diagnosis and treatments of atherosclerotic vessel disease, relations between haemostasis and vascular disease, hypertension, diabetes, immunology and obesity.