Quantifying time from last dose: do direct oral anticoagulant assays correlate with patient's reported last dose.

IF 1.2 4区医学 Q4 HEMATOLOGY

Blood Coagulation & Fibrinolysis Pub Date : 2023-10-01 Epub Date: 2023-09-18 DOI:10.1097/MBC.0000000000001254

Brandon Stretton, Joshua Kovoor, Stephen Bacchi, Aashray Gupta, Suzanne Edwards, Jir Ping Boey, Samuel Gluck, Benjamin Reddi, Guy Maddern, Mark Boyd

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引用次数: 0

Abstract

Introduction: In the absence of a patient's last direct oral anticoagulant (DOAC) dose time, best practice regarding preoperative DOAC cessation remains unclear. The aim of this study was to investigate, in a real-life patient cohort, if there was an association between subjective patient recall and objective DOAC assay titre.

Methods/materials: A multicentre cohort study of consecutive surgical inpatients was conducted. DOAC assays were 'expected' if they satisfied both time and titre-based guidelines.

Results: Patient-recalled last dose and DOAC assay was available in 285 individuals. DOAC assay titres correlated strongly with the expected levels based on a patient's reported last dose time(rho = 0.70, P value < 0.0001). However, underweight (<50 kg; P = 0.0339) and elderly (>80 years; P = 0.0134) were more likely to have an unexpectedly high assay titre.

Conclusions: A significant portion (∼25%) of patients had unexpected DOAC titres. DOAC levels can be clinically impactful in a significant percentage of patients, particularly in elderly and/or underweight.

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最后一次给药后的定量时间：直接进行口服抗凝剂测定，与患者报告的最后一次剂量相关。

引言：在没有患者最后一次直接口服抗凝剂（DOAC）给药时间的情况下，术前停止DOAC的最佳实践尚不清楚。本研究的目的是在现实生活中的患者队列中调查主观患者回忆和客观DOAC测定滴度之间是否存在关联。方法/材料：对连续的外科住院患者进行多中心队列研究。如果DOAC测定同时满足基于时间和滴度的指南，则DOAC测定是“预期的”。结果：患者回忆了最后一次给药，285名患者的DOAC测定可用。DOAC测定滴度与基于患者报告的最后一次给药时间的预期水平密切相关（rho = 0.70，P值<0.0001）。然而，体重不足（80 年；P = 0.0134）更有可能具有出乎意料的高测定滴度。结论：相当一部分（~25%）患者出现了意想不到的DOAC滴度。DOAC水平对很大比例的患者具有临床影响，尤其是老年人和/或体重不足的患者。

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

Blood Coagulation & Fibrinolysis 医学-血液学

CiteScore

1.90

自引率

0.00%

发文量

111

审稿时长

4-8 weeks

期刊介绍： Blood Coagulation & Fibrinolysis is an international fully refereed journal that features review and original research articles on all clinical, laboratory and experimental aspects of haemostasis and thrombosis. The journal is devoted to publishing significant developments worldwide in the field of blood coagulation, fibrinolysis, thrombosis, platelets and the kininogen-kinin system, as well as dealing with those aspects of blood rheology relevant to haemostasis and the effects of drugs on haemostatic components