Monitoring unfractionated heparin therapy with antifactor Xa activity results in fewer monitoring tests and dosage changes than monitoring with the activated partial thromboplastin time
Monitoring unfractionated heparin therapy with antifactor Xa activity results in fewer monitoring tests and dosage changes than monitoring with the activated partial thromboplastin time
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DOI：
10.1592/phco.19.9.760.31547
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发表时间：
1999-06-01
期刊：
影响因子：
4.1
通讯作者：
Rosborough, TK
中科院分区：
文献类型：
--
作者：
Rosborough, TK
研究目的。为了确定通过抗因子 Xa 肝素活性 (HA) 监测普通肝素 (UFH) 治疗的成本比通过活化部分凝血活酶时间 (aPTT) 监测的成本高出多少。设计。前瞻性、随机、非掩蔽、队列、单中心研究。设置。一家拥有 625 个床位、仅限成人入住的私立教学医院。患者。 268 名具有多种 UFH 治疗适应症的患者。干预措施。患者根据理想体重（75 U/kg 推注，20 U/kg 初始输注）接受 UFH 治疗，并通过 HA 或 aPTT 进行监测。测量和主要结果。调整性别后，各组患者特征和 UFH 剂量相当。 HA组每24小时的监测测试和剂量变化少于aPTT组。这些减少抵消了 HA 测定本身增加的大部分成本。结论。使用 HA 检测监测 UFH 治疗超过 96 小时的费用比使用 aPTT 监测的费用高 4.37 美元。考虑到 HA 测定的其他优点，这种适度的增加可能是可以接受的。
Study Objective. To determine how much more costly it is to monitor unfractionated heparin (UFH) therapy by antifactor Xa heparin activity (HA) than by activated partial thromboplastin time (aPTT).Design. Prospective, randomized, unmasked, cohort, single-center study.Setting. A 625-bed, adults-only, private teaching hospital. Patients. Two hundred sixty-eight patients with a variety of indications for UFH therapy.Interventions. Patients were treated with UFH based on ideal weight (75 U/kg bolus, 20 U/kg initial infusion) and monitored by either HA or aPTT.Measurements and Main Results. After adjusting for gender, groups were equivalent in patient characteristics and UFH dosage. The HA group had fewer monitoring tests and dosage changes/24 hours than the aPTT group. These reductions neutralized much of the increased cost of the HA assay itself.Conclusion. Monitoring UFH therapy over 96 hours with an HA assay costs $4.37 more than monitoring with aPTT. This modest increase may be acceptable given other advantages of the HA assay.