![]() ![]() 8 The risk of postsurgical bleeding in patients taking warfarin was reported to be very low in cases of dental extractions, providing that the INR was within an acceptable range when major bleeding does however occur, it can be uncontrollable with local measures and need hospital management. 7 The percentage of bleeding in sites outside the central nervous system was reported to be 7.3%. The percentage of intracranial hemorrhage in the first 3 months after treatment with warfarin was found to be 1.48% with annual percentage of 0.65% 6 this risk was, however, considered unlikely. Such risk of bleeding has been found to be related to many factors, including the intensity of the anticoagulation and in some patients, related factors including age, hypertension, severe cardiac disease, and renal insufficiency. ![]() 5 It has been found that the annual rate of major bleeding in case of patients with atrial fibrillation who receive warfarin treatment is between 0.4 and 2.6. The reported percentage of major bleeding which can be life-threatening in patients taking warfarin ranges from 0.4 to 7.2%, while for minor bleeding, the percentage is approximately 15.4. The recommended INR level according to the American College of Chest Physicians is between 2.0 and 3.0 for most conditions 4 however, patients using prosthetic heart valves may require higher level of INR.Īnticoagulant drugs may put the patient under a risk of bleeding following surgical procedures, and as a result, surgeons are always worried about bleeding in patients undergoing warfarin treatment. 3 The level of INR suitable for the patient depends on the condition of the patient. Its effect is measured by international normalized ratio (INR), which is a measure of patient’s prothrombin time divided by the laboratory control value of prothrombin time. Warfarin has been used to decrease the thromboembolism in millions of patients worldwide. 2 The liver metabolizes warfarin into inactive compounds, which are then excreted, mainly into the urine. 1 Albumin is bound to circulating warfarin, and the half-life of warfarin is approximately 36 hours. The drug can be absorbed completely and reaches its peak in 1 hour after ingestion. A lower INR means your blood clots more quickly than desired.Warfarin, which acts by antagonizing the effect of vitamin K, is one of the most commonly used oral anticoagulants. When the INR is higher than the recommended range, it means that your blood clots more slowly than desired. In certain situations, such as having a mechanical heart valve, you might need a slightly higher INR. These disorders include atrial fibrillation or a blood clot in the leg or lung. An INR range of 2.0 to 3.0 is generally an effective therapeutic range for people taking warfarin for certain disorders. In healthy people an INR of 1.1 or below is considered normal. This ratio - which allows for easier comparisons of test results from different laboratories - is used if you take blood-thinning medications. A number lower than that range means blood clots more quickly than normal. ![]() A number higher than that range means it takes blood longer than usual to clot. The average time range for blood to clot is about 10 to 13 seconds. Prothrombin time test results can be presented in two ways. Home testing kits are available for people who have to take blood thinners for long periods and who have been trained in taking blood samples and testing them. You may receive the test result within minutes, while you are still in the exam room. In some clinics, a nurse will take a sample of your blood with a finger stick. If your provider sends your blood to an off-site laboratory, it may take several days to receive the results. If the laboratory analysis is done on-site, you could have your test results within hours. Your blood might be sent to a laboratory for analysis. Obtaining the blood sample for prothrombin time testing usually takes just a few minutes, like any other blood test. You might experience soreness or minor bruising at the site in the arm where your blood is drawn. A prothrombin time test is similar to any other blood test. ![]()
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