The American Journal of Medicine, Vol 124, No 6, June 2011
"This study is the first to address overanticoagulation management in very old patients; the mean patient age was 86 years, the authors noted. The results are in line with those of nonelderly populations that show low-dose vitamin K1 is more effective in returning INRs to the treatment range than withholding warfarin, they noted. "The effect of (vitamin K1) is valuable, as prolonged exposure to risky INRs may increase the risk of bleeding, especially in the elderly," they wrote. In general, the results suggest that hospitalized elderly patients with INR of 5 to 9, no bleeding and VKA therapy should receive oral vitamin K in a 1 to 2 mg dose, they wrote. Those with an INR of 9 or above and no bleeding should receive doses no greater than 5 mg, they noted, "in order to avoid over-correction."