Associação entre hematúria no EAS e a RNI em pacientes anticoagulados com varfarina
Autor(a) principal: | |
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Data de Publicação: | 2013 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFG |
Texto Completo: | http://repositorio.bc.ufg.br/tede/handle/tede/3410 |
Resumo: | INTRODUCTION: Anticoagulation with warfarin is used in the presence of hypercoagulability and as prophylaxis for thromboembolism. Prothrombin time and activity and the international normalized ratio (PTA/INR) are the standard tests for laboratory follow up of the anticoagulation rate. Hemorrhage is one complication of this therapy. Therefore, one speculates on the possibility of diagnosing cases in which there is excess anticoagulation, by means of the analysis of hematuria in urinalysis and the association with PTA/INR. OBJECTIVE: Analyze the existence of a correlation between hematuria in urinalysis and high PTA/INR, among users of warfarin. METHODOLOGY: This is a descriptive, analytical, primary, quantitative and cross-sectional investigation. The study included 128 patients, 63 of whom were being treated with warfarin, and formed the group of anticoagulated patients (ACG). The remaining 65 patients who were not using anticoagulants formed the non anticoagulated group (NACG). For this study, 152 blood and urine samples were collected; 24 patients of the ACG contributed twice for the PTA/INR and urinalysis, at two different times. All the participants of the NACG also had the PTA/INR and urinalysis tests done. Patients with a clinical suspicion of conditions that might cause hematuria were excluded. The social and demographic data of these individuals were analyzed and the numerical variables of hematuria and of other urinalysis and INR parameters were measured and analyzed. The prevalence and the correlation between hematuria and PTA/INR levels were calculated. Data from the tests, medical appointments and the records of patients recruited in the collection room of the Clinical Laboratory of the HC-UFG were evaluated statistically, and emphasis was placed on the Spearman's correlation for hematuria and PTA/INR (IC 95%; p< 0.05). The study was approved by the Committee on Ethics and Human Research of the HC-UFG, protocol No. 016/2012. RESULTS: The amount of warfarin given on a weekly basis ranged from 10 to 65 mg. If one considers the INR between 2 and 3.9 acceptable for adequate anticoagulation, 59.77% of the individuals were adequately anticoagulated, 35% were insufficiently anticoagulated and 5.75% were excessively anticoagulated. The prevalence of hematuria among the ACG members was 26.44 % (CI 95% 17.98 – 36.43) and among NACG members, 29.23 % (CI 95% 19.16 – 41.11). The correlation coefficient between hematuria and INR was 0.012 (p=0.887). CONCLUSIONS: The most of the patients (59.7%) were within the recommended therapeutic range for controlling patients. There was no correlation between hematuria as measured by urinalysis and anticoagulation levels measured by the INR. |
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Cunha, Luiz Carlos daCunha, Luiz Carlos daSalazar, Vânia Cristina RodriguesAlcântara, Keila Correia deCosta, Paulo Sérgio Sucasas daCosta, Sérgio Henrique Nascentehttp://lattes.cnpq.br/7316612573903069Almeida, Ely Rodrigues de2014-10-20T20:06:38Z2013-10-15ALMEIDA, Ely Rodrigues de. Associação entre hematúria no EAS e a RNI em pacientes anticoagulados com varfarina. 2013. 52 f. Dissertação (Mestrado em Ciências da Saúde) - Universidade Federal de Goiás, Goiânia, 2013.http://repositorio.bc.ufg.br/tede/handle/tede/3410ark:/38995/001300000dnqtINTRODUCTION: Anticoagulation with warfarin is used in the presence of hypercoagulability and as prophylaxis for thromboembolism. Prothrombin time and activity and the international normalized ratio (PTA/INR) are the standard tests for laboratory follow up of the anticoagulation rate. Hemorrhage is one complication of this therapy. Therefore, one speculates on the possibility of diagnosing cases in which there is excess anticoagulation, by means of the analysis of hematuria in urinalysis and the association with PTA/INR. OBJECTIVE: Analyze the existence of a correlation between hematuria in urinalysis and high PTA/INR, among users of warfarin. METHODOLOGY: This is a descriptive, analytical, primary, quantitative and cross-sectional investigation. The study included 128 patients, 63 of whom were being treated with warfarin, and formed the group of anticoagulated patients (ACG). The remaining 65 patients who were not using anticoagulants formed the non anticoagulated group (NACG). For this study, 152 blood and urine samples were collected; 24 patients of the ACG contributed twice for the PTA/INR and urinalysis, at two different times. All the participants of the NACG also had the PTA/INR and urinalysis tests done. Patients with a clinical suspicion of conditions that might cause hematuria were excluded. The social and demographic data of these individuals were analyzed and the numerical variables of hematuria and of other urinalysis and INR parameters were measured and analyzed. The prevalence and the correlation between hematuria and PTA/INR levels were calculated. Data from the tests, medical appointments and the records of patients recruited in the collection room of the Clinical Laboratory of the HC-UFG were evaluated statistically, and emphasis was placed on the Spearman's correlation for hematuria and PTA/INR (IC 95%; p< 0.05). The study was approved by the Committee on Ethics and Human Research of the HC-UFG, protocol No. 016/2012. RESULTS: The amount of warfarin given on a weekly basis ranged from 10 to 65 mg. If one considers the INR between 2 and 3.9 acceptable for adequate anticoagulation, 59.77% of the individuals were adequately anticoagulated, 35% were insufficiently anticoagulated and 5.75% were excessively anticoagulated. The prevalence of hematuria among the ACG members was 26.44 % (CI 95% 17.98 – 36.43) and among NACG members, 29.23 % (CI 95% 19.16 – 41.11). The correlation coefficient between hematuria and INR was 0.012 (p=0.887). CONCLUSIONS: The most of the patients (59.7%) were within the recommended therapeutic range for controlling patients. There was no correlation between hematuria as measured by urinalysis and anticoagulation levels measured by the INR.INTRODUÇÃO: A anticoagulação com varfarina é usada na hipercoagubilidade e como profilaxia para o tromboembolismo. O tempo e atividade de protrombina e a relação normatizada internacional (TAP/RNI) são os exames padrões para acompanhamento laboratorial da taxa de anticoagulação. A hemorragia é uma complicação desta terapia. Dessa forma, especula-se a possibilidade de diagnosticar casos em que haja excesso de anticoagulação, por meio da análise da hematúria no exame dos elementos anormais e sedimentoscopia da urina (EAS) e a associação com TAP/RNI. OBJETIVO: Analisar a existência de correlação entre hematúria no EAS e TAP /RNI elevados, nos usuários do anticoagulante varfarina. METODOLOGIA: Estudo descritivo, analítico, primário, quantitativo e transversal. Incluíram-se 128 pacientes, sendo 63 tratados com varfarina, formando um grupo anticoagulado (GAC) e 65 que não faziam uso de anticoagulantes, grupo não anticoagulado (GNAC). Colheram-se 152 amostras de sangue e urina; das quais 24 pacientes do GAC contribuíram duas vezes para exames TAP/RNI e EAS, em dois momentos distintos. Todos os participantes do GNAC também se submeteram aos exames TAP/RNI e EAS. Excluíram-se pacientes com suspeita clínica de condições que causassem hematúria. Analisaram-se os dados sociodemográficos e fez-se a mensuração e a análise das variáveis numéricas hematúria e de outros parâmetros do EAS e RNI. Calculou-se a prevalência e a correlação entre hematúria e níveis de TAP/RNI. Os dados oriundos de exames, consultas médicas e dos prontuários dos pacientes recrutados na sala de coleta do Laboratório Clinico do HC-UFG, foram avaliados estatisticamente, com ênfase na correlação de Spearman para hematúria e TAP/RNI (IC 95%; p<0,05). O projeto foi aprovado pelo Comitê de Ética e Pesquisa Humana do HC-UFG sob o nº 016/2012. RESULTADOS: A quantidade de varfarina semanal variou de 10 a 65 mg. Considerando-se o valor de RNI entre 2 e 3,9, como valor aceitável para adequada anticoagulação, 59,77% estavam adequadamente anticoagulados, 35% insuficientemente e, com efeito anticoagulante excessivo, 5,75%. A prevalência de hematúria no GAC foi de 26,44 % (IC 95% 17,98 – 36,43) e no GNAC, foi de 29,23 % (IC 95% 19,16 – 41,11). O coeficiente de correlação entre hematúria e RNI foi de 0,012 (p=0,887). CONCLUSÕES: A maioria dos pacientes (59,7%) tinha a RNI na faixa terapêutica preconizada para anticoagulação. Não houve correlação entre hematúria ao exame EAS e os níveis de anticoagulação medidos pela RNI.Submitted by Cássia Santos (cassia.bcufg@gmail.com) on 2014-10-16T15:13:44Z No. of bitstreams: 2 Dissertacao Ely Rodrigues de Almeida - 2013.pdf: 1560361 bytes, checksum: 153a2514b81e70d5b31e01a1cc0d09b6 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5)Approved for entry into archive by Jaqueline Silva (jtas29@gmail.com) on 2014-10-20T20:06:38Z (GMT) No. of bitstreams: 2 Dissertacao Ely Rodrigues de Almeida - 2013.pdf: 1560361 bytes, checksum: 153a2514b81e70d5b31e01a1cc0d09b6 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5)Made available in DSpace on 2014-10-20T20:06:38Z (GMT). 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dc.title.por.fl_str_mv |
Associação entre hematúria no EAS e a RNI em pacientes anticoagulados com varfarina |
dc.title.alternative.eng.fl_str_mv |
Association betwenn hematuria in UA and the INR in patients anticoagulated with warfarin |
title |
Associação entre hematúria no EAS e a RNI em pacientes anticoagulados com varfarina |
spellingShingle |
Associação entre hematúria no EAS e a RNI em pacientes anticoagulados com varfarina Almeida, Ely Rodrigues de Varfarina RNI Hematúria Warfarin INR Hematuria MEDICINA::CLINICA MEDICA |
title_short |
Associação entre hematúria no EAS e a RNI em pacientes anticoagulados com varfarina |
title_full |
Associação entre hematúria no EAS e a RNI em pacientes anticoagulados com varfarina |
title_fullStr |
Associação entre hematúria no EAS e a RNI em pacientes anticoagulados com varfarina |
title_full_unstemmed |
Associação entre hematúria no EAS e a RNI em pacientes anticoagulados com varfarina |
title_sort |
Associação entre hematúria no EAS e a RNI em pacientes anticoagulados com varfarina |
author |
Almeida, Ely Rodrigues de |
author_facet |
Almeida, Ely Rodrigues de |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Cunha, Luiz Carlos da |
dc.contributor.referee1.fl_str_mv |
Cunha, Luiz Carlos da |
dc.contributor.referee2.fl_str_mv |
Salazar, Vânia Cristina Rodrigues |
dc.contributor.referee3.fl_str_mv |
Alcântara, Keila Correia de |
dc.contributor.referee4.fl_str_mv |
Costa, Paulo Sérgio Sucasas da |
dc.contributor.referee5.fl_str_mv |
Costa, Sérgio Henrique Nascente |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/7316612573903069 |
dc.contributor.author.fl_str_mv |
Almeida, Ely Rodrigues de |
contributor_str_mv |
Cunha, Luiz Carlos da Cunha, Luiz Carlos da Salazar, Vânia Cristina Rodrigues Alcântara, Keila Correia de Costa, Paulo Sérgio Sucasas da Costa, Sérgio Henrique Nascente |
dc.subject.por.fl_str_mv |
Varfarina RNI Hematúria |
topic |
Varfarina RNI Hematúria Warfarin INR Hematuria MEDICINA::CLINICA MEDICA |
dc.subject.eng.fl_str_mv |
Warfarin INR Hematuria |
dc.subject.cnpq.fl_str_mv |
MEDICINA::CLINICA MEDICA |
description |
INTRODUCTION: Anticoagulation with warfarin is used in the presence of hypercoagulability and as prophylaxis for thromboembolism. Prothrombin time and activity and the international normalized ratio (PTA/INR) are the standard tests for laboratory follow up of the anticoagulation rate. Hemorrhage is one complication of this therapy. Therefore, one speculates on the possibility of diagnosing cases in which there is excess anticoagulation, by means of the analysis of hematuria in urinalysis and the association with PTA/INR. OBJECTIVE: Analyze the existence of a correlation between hematuria in urinalysis and high PTA/INR, among users of warfarin. METHODOLOGY: This is a descriptive, analytical, primary, quantitative and cross-sectional investigation. The study included 128 patients, 63 of whom were being treated with warfarin, and formed the group of anticoagulated patients (ACG). The remaining 65 patients who were not using anticoagulants formed the non anticoagulated group (NACG). For this study, 152 blood and urine samples were collected; 24 patients of the ACG contributed twice for the PTA/INR and urinalysis, at two different times. All the participants of the NACG also had the PTA/INR and urinalysis tests done. Patients with a clinical suspicion of conditions that might cause hematuria were excluded. The social and demographic data of these individuals were analyzed and the numerical variables of hematuria and of other urinalysis and INR parameters were measured and analyzed. The prevalence and the correlation between hematuria and PTA/INR levels were calculated. Data from the tests, medical appointments and the records of patients recruited in the collection room of the Clinical Laboratory of the HC-UFG were evaluated statistically, and emphasis was placed on the Spearman's correlation for hematuria and PTA/INR (IC 95%; p< 0.05). The study was approved by the Committee on Ethics and Human Research of the HC-UFG, protocol No. 016/2012. RESULTS: The amount of warfarin given on a weekly basis ranged from 10 to 65 mg. If one considers the INR between 2 and 3.9 acceptable for adequate anticoagulation, 59.77% of the individuals were adequately anticoagulated, 35% were insufficiently anticoagulated and 5.75% were excessively anticoagulated. The prevalence of hematuria among the ACG members was 26.44 % (CI 95% 17.98 – 36.43) and among NACG members, 29.23 % (CI 95% 19.16 – 41.11). The correlation coefficient between hematuria and INR was 0.012 (p=0.887). CONCLUSIONS: The most of the patients (59.7%) were within the recommended therapeutic range for controlling patients. There was no correlation between hematuria as measured by urinalysis and anticoagulation levels measured by the INR. |
publishDate |
2013 |
dc.date.issued.fl_str_mv |
2013-10-15 |
dc.date.accessioned.fl_str_mv |
2014-10-20T20:06:38Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
ALMEIDA, Ely Rodrigues de. Associação entre hematúria no EAS e a RNI em pacientes anticoagulados com varfarina. 2013. 52 f. Dissertação (Mestrado em Ciências da Saúde) - Universidade Federal de Goiás, Goiânia, 2013. |
dc.identifier.uri.fl_str_mv |
http://repositorio.bc.ufg.br/tede/handle/tede/3410 |
dc.identifier.dark.fl_str_mv |
ark:/38995/001300000dnqt |
identifier_str_mv |
ALMEIDA, Ely Rodrigues de. Associação entre hematúria no EAS e a RNI em pacientes anticoagulados com varfarina. 2013. 52 f. Dissertação (Mestrado em Ciências da Saúde) - Universidade Federal de Goiás, Goiânia, 2013. ark:/38995/001300000dnqt |
url |
http://repositorio.bc.ufg.br/tede/handle/tede/3410 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.program.fl_str_mv |
-1006864312617745310 |
dc.relation.confidence.fl_str_mv |
600 600 600 |
dc.relation.department.fl_str_mv |
1545772475950486338 |
dc.relation.cnpq.fl_str_mv |
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