The use of warfarin in veterans with atrial fibrillation

被引：14

作者：

Bravata D.M. ^{[1
,2
,5
]}

Rosenbeck K. ^{[3
]}

Kancir S. ^{[3
]}

Brass L.M. ^{[4
,5
]}

机构：

[1] Clinical Epidemiology Research Ctr., VA Connecticut Healthcare System, West Haven, CT 06516

[2] Department of Internal Medicine, VA Connecticut Healthcare System, West Haven, CT 06516

[3] Department of Quality Management, VA Connecticut Healthcare System, West Haven, CT 06516

[4] Department of Neurology, VA Connecticut Healthcare System, West Haven, CT 06516

[5] Yale University School of Medicine, New Haven, CT 06520-8088

来源：

BMC Cardiovascular Disorders | / 4卷 / 1期

关键词：

Anticoagulation; Atrial fibrillation; Guideline adherence; Preventive medicine; Warfarin;

D O I：

10.1186/1471-2261-4-18

中图分类号：

学科分类号：

摘要：

Background: Warfarin therapy is effective for the prevention of stroke in patients with atrial fibrillation. However, warfarin therapy is underutilized even among ideal anticoagulation candidates. The purpose of this study was to examine the use of warfarin in both inpatients and outpatients with atrial fibrillation within a Veterans Affairs (VA) hospital system. Methods: This retrospective medical record review included outpatients and inpatients with atrial fibrillation. The outpatient cohort included all patients seen in the outpatient clinics of the VA Connecticut Healthcare System during June 2000 with a diagnosis of atrial fibrillation. The inpatient cohort included all patients discharged from the VA Connecticut Healthcare System West Haven Medical Center with a diagnosis of atrial fibrillation during October 1999 - March 2000. The outcome measure was the rate of warfarin prescription in patients with atrial fibrillation. Results: A total of 538 outpatients had a diagnosis of atrial fibrillation and 73 of these had a documented contraindication to anticoagulation. Among the 465 eligible outpatients, 455 (98%) were prescribed warfarin. For the inpatients, a total of 212 individual patients were discharged with a diagnosis of atrial fibrillation and 97 were not eligible for warfarin therapy. Among the 115 eligible inpatients, 106 (92%) were discharged on warfarin. Conclusions: Ideal anticoagulation candidates with atrial fibrillation are being prescribed warfarin at very high rates within one VA system, in both the inpatient and outpatient settings; we found warfarin use within our VA was much higher than that observed for Medicare beneficiaries in our state. © 2004 Bravata et al; licensee BioMed Central Ltd.

引用

页数：6

共 14 条

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