Clinical and Applied Thrombosis/Hemostasis (Nov 2021)

Appropriateness of Using Vitamin K for the Correction of INR Elevation Secondary to Hepatic Disease in Critically ill Patients: An Observational Study

  • Khalid Al Sulaiman,
  • Mashael Al Mutairi,
  • Omar Al Harbi,
  • Alanoud Al Duraihim,
  • Sara Aldosary,
  • Haifa Al Khalil,
  • Abdulrahman Al Shaya,
  • Shmeylan Al Harbi,
  • Nouf Alotaibi,
  • Kholoud Al Aamer,
  • Ramesh Vishwakarma,
  • Mohammed Al Asiri,
  • Ohoud Aljuhani,
  • Abdulmalik Al Katheri,
  • Abdulkareem M. Al Bekairy

DOI
https://doi.org/10.1177/10760296211050923
Journal volume & issue
Vol. 27

Abstract

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Background Using vitamin K for correction of coagulopathy in critically ill patients is controversial with limited evidence. This study aims to evaluate the efficacy and safety of vitamin K in the correction of international normalized ratio (INR) elevation secondary to liver disease in critically ill patients. Method A retrospective study of critically ill patients with coagulopathy secondary to liver disease. The primary outcome was to evaluate the association between vitamin K administration and the incidence of new bleeding events in critically ill patients with INR elevation; other outcomes were considered secondary. Patients were categorized into two groups based on vitamin K administration to correct INR elevation. The propensity score was generated based on disease severity scores and the use of pharmacological DVT prophylaxis. Results A total of 98 patients were included in the study. Forty-seven patients (48%) received vitamin K during the study period. The odds of the new bleeding event was not statistically different between groups (OR 2.4, 95% CI 0.28-21.67, P = .42). Delta of INR reduction was observed with a median of 0.63 when the first dose is given ( P -value: <.0001). However the INR reduction with other subsequent doses of vitamin K was not statistically significant. Conclusion The administration of vitamin K for INR correction in critically ill patients with coagulopathy secondary to liver disease was not associated with a lower odds of new bleeding events. Further studies are needed to assess the value of vitamin K administration in critically ill patients with liver diseases related coagulopathy.