Ann Pharmacother November 18, 2015 1060028015617277
Adam V. Meyer, MD1; Melissa Green 2; Heather M. Pautler, PharmD, BCPS3; Kevin Korenblat, MD1
Eli N. Deal, PharmD, BCPS3⇑
Mark S. Thoelke, MD1
1 Washington University in St Louis School of Medicine, St. Louis, MO, USA
2 St Louis College of Pharmacy, St. Louis, MO, USA
3 Barnes-Jewish Hospital, St. Louis, MO, USA
Eli N. Deal, Department of Pharmacy, Barnes-Jewish Hospital, 216 S Kingshighway Blvd, St Louis, MO 63110, USA. Email: end0164 at bjc.org
The abstract fails to tell the Vitamin K dose size
The abstract fails to distinguish if dose was K1 or K2
The publisher wants $36 for the PDF which probably has that information
See also VitaminDWiki
- Liver failure in ICU – 2.5X more likely to die in within six months if very low vitamin D – Oct 2018
- Cirrhosis infection and death both associated with low vitamin D – June 2015
- Advanced liver cirrhosis death 6.3X more likely if extremely low vitamin D – Jan 2013
- Overview Liver and vitamin D
- Search for CIRRHOSIS in VitaminDWiki 174 items Nov 2015
- Soft Bones, Hard Arteries, Vitamin D, Vitamin K2 and antibiotics – Sept 2012
The liver processes BOTH vitamin D and vitamin K
Pages listed in BOTH the categories Vitamin K and Liver
Background: The efficacy of vitamin K in lowering an elevated INR in the setting of cirrhosis is not well established.
Objectives: The purpose of this investigation is to determine the effect of vitamin K administration on the INR and bleeding events among hospitalized patients with cirrhosis.
Methods: This is a retrospective investigation of patients hospitalized at an academic institution from 2010 to 2012. Adults with an ICD9 code supporting cirrhosis were segregated into matched cohorts based on provision of vitamin K. Multivariable logistic regression of factors associated with INR decrease and bleeding events was completed.
Results: The final matched cohort (n = 276) contained 130 patients who received vitamin K and 146 who did not receive this therapy.
- ICU care (adjusted odds ratio [AOR] = 2.91; 95% CI = 1.54-5.49; P = 0.01),
- receipt of a blood product (AOR = 2.40; 95%CI = 1.35-4.24; P = 0.03), and
- baseline INR > 1.6 (AOR = 1.72; 95% CI = 1.00-2.95; P = 0.05),
but not vitamin K administration (AOR = 1.17; 95% CI = 0.66-2.08; P = 0.59), were associated with INR decrease.
Bleeding events occurred more frequently among patients with a history of esophageal varices (AOR = 6.35; 95% CI = 1.21-33.4; P = 0.03), but vitamin K administration did not have an impact on these events (AOR = 4.90; 95% CI = 0.56-43.0; P = 0.15).
Conclusions: Administration of vitamin K did not affect INR changes or bleeding events in this cohort of hospitalized patients with cirrhosis.