EVIDENCE BASED MEDICINE
EBM - November 30, 2016 - By mizzouem
"In patients on warfarin presenting to the ED with asymptomatic supratherapeutic INR greater than 3.5, is treatment with vitamin K compare to no treatment with vitamin K associated with worse outcomes defined as increased risk of major bleeding?...
Bottom Line
There is low risk of bleeding in patients with supratherapeutic INR. Outpatient management is recommended, but close follow up is key. There should be an emphasis on not creating warfarin resistance or making the patient subtherapeutic. Vitamin K should be used in those with INR>5 and increased risk of bleeding. Higher doses of vitamin K should be used in all patients with INR>9."