Assessment of agreement and time in therapeutic range of capillary versus venous international normalised ratio in frail elderly people in a nursing home

Intern Med J. 2019 Nov;49(11):1442-1446. doi: 10.1111/imj.14626.

Abstract

Vitamin K antagonists are widely used, yet have a slim therapeutic margin and high iatrogenicity. Patients are monitored through international normalised ratio (INR) by venipuncture, but coagulometers could measure INR by capillary puncture. This prospective study evaluated the clinical concordance of capillary INR versus venous INR in 31 nursing home patients. Concordance was good and mean time in therapeutic range (TTR) markedly increased. Capillary INR is thus reliable, could improve TTR and decrease iatrogenicity.

Keywords: coagulometer; elderly; international normalised ratio; point-of-care testing; vitamin K antagonist.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Aged, 80 and over
  • Anticoagulants / therapeutic use
  • Capillaries
  • Drug Monitoring / instrumentation
  • Drug Monitoring / standards
  • Female
  • Fibrinolytic Agents / therapeutic use
  • Frail Elderly
  • France
  • Homes for the Aged
  • Humans
  • International Normalized Ratio / instrumentation*
  • International Normalized Ratio / standards
  • Male
  • Nursing Homes
  • Phlebotomy / methods*
  • Point-of-Care Systems / standards*
  • Prospective Studies
  • Veins
  • Vitamin K / antagonists & inhibitors

Substances

  • Anticoagulants
  • Fibrinolytic Agents
  • Vitamin K