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Related Experiment Videos

Unfractionated heparin, time for a change?

P F Ridgway1, J Crosbie, K A Hinedi

  • 1Dept. of Medicine, Beaumont Hospital, Dublin, Ireland.

Irish Medical Journal
|July 8, 1999
PubMed
Summary

Unfractionated Heparin use for venous thromboembolism in Ireland resulted in suboptimal anticoagulation and prolonged hospital stays. Low Molecular Weight Heparin may offer better outcomes and cost-effectiveness.

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Area of Science:

  • Medical Science
  • Pharmacology
  • Clinical Medicine

Background:

  • Physician adoption of Low Molecular Weight Heparin (LMWH) for venous thromboembolism (VTE) in Ireland lags despite evidence.
  • Concerns exist regarding the anticoagulation levels achieved with Unfractionated Heparin (UFH).

Purpose of the Study:

  • To evaluate the effectiveness of Unfractionated Heparin (UFH) administration in an Irish teaching hospital.
  • Primary outcomes included time to therapeutic activated partial thromboplastin time (APTT) and hospital length of stay.

Main Methods:

  • A retrospective analysis of 50 consecutive VTE patients treated with continuous intravenous UFH from August 1994 to December 1996.
  • Data collected included length of stay, costs, and anticoagulation parameters (time to therapeutic APTT, time within range, diagnostic tests, dosage).

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Main Results:

  • 22% of patients never achieved therapeutic APTT; only 28% of those who did remained within range.
  • 57% of results were sub-therapeutic, 15% supra-therapeutic; 26% discharged with out-of-range INR.
  • Ineffective anticoagulation prolonged hospital stays in 60% of cases; UFH cost was significantly higher than projected LMWH costs.

Conclusions:

  • Unfractionated Heparin therapy in this study was sub-optimal, leading to inadequate anticoagulation and prolonged hospitalizations.
  • Low Molecular Weight Heparin may offer comparable therapeutic effects and potentially lower overall costs.