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Phytonadione Utilization and the Risk of Bleeding in Chronic Liver Disease
Joanna He1, Tessa R Cox2, Brian W Gilbert2
1Ochsner LSU Health Shreveport, Shreveport, LA, USA.
Hospital Pharmacy
|October 28, 2024
Summary
Phytonadione did not reduce bleeding risk or international normalized ratio (INR) in non-bleeding patients with chronic liver disease. This study found no significant difference in new bleeding or thrombosis incidence between groups.
Area of Science:
- Hepatology
- Pharmacology
- Clinical Medicine
Background:
- Chronic liver disease often leads to coagulopathy and elevated international normalized ratio (INR).
- Phytonadione (vitamin K1) is used to correct coagulopathy, but its efficacy in non-bleeding chronic liver disease patients is unclear.
Purpose of the Study:
- To evaluate the safety and efficacy of phytonadione in patients with elevated INR due to chronic liver disease without active bleeding.
- To assess the impact of phytonadione on new bleeding incidence, thrombosis, and INR levels.
Main Methods:
- Retrospective chart review of hospitalized patients (2015-2022) with chronic liver disease and baseline INR of 1.2-1.9.
- Comparison between patients who received phytonadione and those who did not, focusing on new bleeding events.
- Analysis of thrombosis incidence and changes in INR post-intervention.
Main Results:
- 133 patients included; 46 received phytonadione (mean 2.46 doses, 7.95 mg).
- No significant difference in new bleeding (9.20% vs 13.04%) or thrombosis (3.45% vs 0%) between groups.
- Phytonadione did not alter INR, while INR increased in the control group (0.24, P=.025).
Conclusions:
- Phytonadione administration did not reduce INR in non-bleeding chronic liver disease patients.
- Phytonadione did not decrease the incidence of new bleeding or thrombosis in this patient population.
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