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[Vitamine K antagonists overdose: Physician adherence to the French guidelines]
E Oliosi1, O Pointeau1, E Mazoyer2
1Unité HTA et maladies des vaisseaux, médecine interne, hôpital Avicenne, 125, route de Stalingrad, 93000 Bobigny, France.
Introduction:
Vitamin K antagonists (VKA) are drugs with a major risk of side effect. Guidelines have been published in 2008 by the Haute Autorité de santé (HAS) concerning the management of an excessively elevated INR ratio. Our research aimed to assess physicians' adherence to those guidelines.
Methods:
We realized a retrospective, multicentric study. One hundred and ten cases of excessively elevated INR ratio were identified and analyzed.
Results:
Overall physicians adherence was 58%. However, patients with the most elevated INR, i.e., INR>6, were treated according to guidelines in only 33% of the cases. The use of vitamin K was the major source of mistakes. The rate of mortality was 20%.
Conclusion:
Adherence to HAS guidelines seems finally limited. It is necessary to put in place procedures to secure the behavior of physicians.
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