Table 2 Association of factors with warfarin prescribing
From: Use of warfarin in long-term care: a systematic review
Category | Factor | Direction of association (at 95% confidence) 0 = none + = positive - = negative | Association (multivariate adjusted) (OR, 95% CI) | Endpoint | Study Condition | Study |
|---|---|---|---|---|---|---|
Admission | Admitted from hospital | + | OR = 1.16 (1.02-1.31) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | 0 | OR = 1.12 (0.97-1.29) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
Age | 65-74 | 0 | OR = 0.98 (0.61-1.57) | use of warfarin | AF | Lau et al. (2004) [10] |
| Â | 75-84 | 0 | OR = 0.98 (0.61-1.58) | use of warfarin | AF | Lau et al. (2004) [10] |
| Â | Â | 0 | OR = 1.13 (0.98-1.31) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | 0 | OR = 0.99 (0.94-1.04) | use of warfarin or antiplatelets | Previous stroke | Quilliam et al. (2001) [12] |
| Â | Â | 0 | not reported | use of warfarin | AF | Gurwitz et al. (1997) [8] |
| Â | Â | 0 | OR = 1.01 (0.86-1.19) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
|  | ≥ 85 | 0 | OR = 1.13 (0.70-1.82) | use of warfarin | AF | Lau et al. (2004) [10] |
| Â | Â | 0 | OR = 1.07 (CI not reported) | use of warfarin or antiplatelets | Previous stroke | Sloane et al. (2004) [13] |
| Â | Â | + | OR = 1.23 (1.05-1.43) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | - | OR = 0.46 (0.22-0.94) | use of warfarin | AF | Gurwitz et al. (1997) [8] |
| Â | Â | - | OR = 0.86 (0.82-0.91) | use of warfarin or antiplatelets | Previous stroke | Quilliam et al. (2001) [12] |
| Â | Â | 0 | OR = 0.86 (0.72-1.04) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
Bleeding risk | 1 risk factor | 0 | OR = 0.75 (0.41-1.36) | use of warfarin | AF | McCormick et al. (2001) [11] |
|  | ≥ 2 risk factors | - | OR = 0.51 (0.29-0.94) | use of warfarin | AF | McCormick et al. (2001) [11] |
| Â | High risk | 0 | OR = 0.82 (0.52-1.30) | use of warfarin | AF | Lau et al. (2004) [10] |
Cognitive impairment | Moderate | - | OR = 0.93 (0.88-0.97) | use of warfarin or antiplatelets | Previous stroke | Quilliam et al. (2001) [12] |
| Â | Â | 0 | OR = 0.93 (0.81-1.08) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | 0 | OR = 0.98 (0.86-1.12) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Severe | 0 | OR = 1.19 (0.99-1.44) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | - | OR = 0.64 (0.52-0.80) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | - | OR = 0.63 (0.60-0.67) | use of warfarin or antiplatelets | Previous stroke | Quilliam et al. (2001) [12] |
| Â | Â | 0 | OR = 1.02 (CI not reported) | use of warfarin or antiplatelets | Previous stroke | Sloane et al. (2004) [13] |
Conditions | Active malignancy | 0 | OR = 0.93 (0.57-1.51) | use of warfarin | AF | Lau et al. (2004)[10] |
| Â | Alzheimer's disease | - | OR = 0.77 (0.70-0.85) | use of warfarin or antiplatelets | Previous stroke | Quilliam et al. (2001) [12] |
| Â | Anemia | 0 | OR = 0.87 (0.55-1.39) | use of warfarin | AF | Lau et al. (2004) [10] |
| Â | Aneurysms | 0 | OR = 0.88 (0.55-1.40) | use of warfarin | AF | Lau et al. (2004) [10] |
| Â | Atrial fibrillation | - | OR = 0.73 (0.64-0.83) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | + | OR = 1.76 (1.50-2.06) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | + | OR = 2.04 (1.95-2.14) | use of warfarin or antiplatelets | Previous stroke | Quilliam et al. (2001) [12] |
| Â | Congestive heart failure | 0 | OR = 1.13 (0.98-1.30) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | 0 | OR = 1.04 (0.65-1.65) | use of warfarin | AF | Lau et al. (2004) [10] |
| Â | Â | 0 | not reported | use of warfarin | AF | Abdel-Latif et al. (2005) [7] |
| Â | Â | 0 | OR = 1.02 (0.87-1.20) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Coronary artery disease | + | OR = 1.06 (1.02-1.11) | use of warfarin or antiplatelets | Previous stroke | Quilliam et al. (2001) [12] |
| Â | Â | 0 | OR = 0.99 (0.62-1.58) | use of warfarin | AF | Lau et al. (2004) [10] |
| Â | Dementia | - | OR = 0.84 (0.80-0.88) | use of warfarin or antiplatelets | Previous stroke | Quilliam et al. (2001) [12] |
| Â | Â | - | OR = 0.59 (0.38-0.90) | use of warfarin | AF | Gurwitz et al. (1997) [8] |
| Â | Depression | + | OR = 1.22 (1.02-1.46) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | + | OR = 1.11 (1.05-1.18) | use of warfarin or antiplatelets | Previous stroke | Quilliam et al. (2001) [12] |
| Â | Â | 0 | OR = 1.08 (0.93-1.24) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Diabetes mellitus | 0 | not reported | use of warfarin | AF | Abdel-Latif et al. (2005) [7] |
| Â | Â | 0 | OR = 1.17 (0.73-1.86) | use of warfarin | AF | Lau et al. (2004) [10] |
| Â | Hypertension | - | OR = 0.87 (0.78-0.97) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | + | OR = 1.23 (1.09-1.39) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | 0 | OR = 1.10 (0.69-1.75) | use of warfarin | AF | Lau et al. (2004) [10] |
| Â | Â | 0 | not reported | use of warfarin | AF | Abdel-Latif et al. (2005) [7] |
| Â | Â | + | OR = 1.27 (1.22-1.32) | use of warfarin or antiplatelets | Previous stroke | Quilliam et al. (2001) [12] |
| Â | Left ventricular dysfunction | 0 | OR = 0.83 (0.63-1.09) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | 0 | OR = 1.07 (0.88-1.30) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Liver disease | 0 | OR = 1.53 (0.95-2.49) | use of warfarin | AF | Lau et al. (2004) [10] |
| Â | Major comorbidity burden | 0 | not reported | use of warfarin | AF | Gurwitz et al. (1997) [8] |
| Â | Moderate comorbidity burden | 0 | not reported | use of warfarin | AF | Gurwitz et al. (1997) [8] |
| Â | Multiple conditions (4 or more) | 0 | OR = 0.84 (CI not reported) | use of warfarin or antiplatelets | Previous stroke | Sloane et al. (2004) [13] |
| Â | Peptic ulcer disease | 0 | OR = 0.90 (0.57-1.43) | use of warfarin | AF | Lau et al. (2004) [10] |
| Â | Â | - | OR = 0.64 (0.58-0.71) | use of warfarin or antiplatelets | Previous stroke | Quilliam et al. (2001) [12] |
| Â | Peripheral vascular disease | + | OR = 1.13 (1.05-1.20) | use of warfarin or antiplatelets | Previous stroke | Quilliam et al. (2001) [12] |
| Â | Previous bleeding | 0 | not reported | use of warfarin | AF | Gurwitz et al. (1997) [8] |
| Â | Previous falls | 0 | not reported | use of warfarin | AF | Gurwitz et al. (1997) [8] |
| Â | Previous GI bleeding | - | OR = 0.57 (0.52-0.62) | use of warfarin or antiplatelets | Previous stroke | Quilliam et al. (2001) [12] |
| Â | Â | - | OR = 0.18 (0.03-0.91) | use of warfarin | AF | Abdel-Latif et al. (2005) [7] |
| Â | Previous major bleeding | 0 | OR = 0.73 (0.46-1.15) | use of warfarin | AF | Lau et al. (2004) [10] |
| Â | Previous stroke | + | OR = 4.93 (2.11-11.49) | use of warfarin | AF | Abdel-Latif et al. (2005) [7] |
| Â | Â | + | OR = 1.87 (1.20-2.91) | use of warfarin | AF | Gurwitz et al. (1997) [8] |
| Â | Previous stroke or TIA | 0 | OR = 1.24 (0.78-1.97) | use of warfarin | AF | Lau et al. (2004) [10] |
| Â | Previous systemic embolus | 0 | OR = 1.46 (0.92-2.34) | use of warfarin | AF | Lau et al. (2004) [10] |
| Â | Recent surgery | - | OR = 0.59 (0.37-0.94) | use of warfarin | AF | Lau et al. (2004) [10] |
| Â | Renal insufficiency | 0 | OR = 0.91 (0.57-1.45) | use of warfarin | AF | Lau et al. (2004) [10] |
| Â | Rheumatic mitral valvular | 0 | OR = 0.80 (0.50-1.28) | use of warfarin | AF | Lau et al. (2004) [10] |
| Â | Seizure disorder | 0 | OR = 1.05 (0.66-1.67) | use of warfarin | AF | Lau et al. (2004) [10] |
| Â | Transient ischemic attack | + | OR = 1.34 (1.09-1.64) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | 0 | OR = 0.99 (0.84-1.17) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
Drug Interaction | Uses meds that increase bleeding risk | 0 | not reported | use of warfarin | AF | Gurwitz et al. (1997) [8] |
| Â | Â | 0 | OR = 1.26 (0.80-1.98) | use of warfarin | AF | Lau et al. (2004) [10] |
Duration of AF | 12-24 months | 0 | not reported | use of warfarin | AF | Gurwitz et al. (1997) [8] |
| Â | > 24 months | 0 | not reported | use of warfarin | AF | Gurwitz et al. (1997) [8] |
| Â | Onset of AF after admission | 0 | not reported | use of warfarin | AF | Gurwitz et al. (1997) [8] |
Facility | Alzheimer's unit | 0 | OR = 0.78 (0.57-1.05) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | 0 | OR = 1.14 (0.80-1.62) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Hospital based | 0 | OR = 0.96 (0.72-1.29) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | 0 | OR = 0.96 (0.75-1.23) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Location rural | 0 | OR = 0.89 (CI not reported) | use of warfarin or antiplatelets | Previous stroke | Sloane et al. (2004) [13] |
| Â | Location urban | + | OR = 1.38 (1.16-1.65) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | 0 | OR = 1.06 (0.87-1.3) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Large new model facility (vs small) | 0 | OR = 0.61 (CI not reported) | use of warfarin or antiplatelets | Previous stroke | Sloane et al. (2004) [13] |
| Â | Non-white > 10% (vs > 0% to < 5%) | 0 | OR = 1.09 (0.91-1.32) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | + | OR = 1.22 (1.03-1.43) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Non-white > 5% to < 10% (vs > 0% to < 5%) | 0 | OR = 1.00 (0.81-1.24) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | 0 | OR = 0.95 (0.78-1.15) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Non-white 0% (vs > 0% to < 5%) | - | OR = 0.74 (0.57-0.96) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | 0 | OR = 1.17 (0.93-1.46) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Ownership status for profit (vs non-profit) | 0 | OR = 0.90 (0.76-1.07) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | 0 | OR = 0.90 (0.77-1.05) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Ownership status government (vs non-profit) | 0 | OR = 0.86 (0.64-1.17) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | 0 | OR = 0.99 (0.76-1.29) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Part of a chain | + | OR = 1.20 (1.01-1.42) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | - | OR = 0.85 (0.73-0.99) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Payment source % Medicaid (per 10 unit increase) | 0 | OR = 0.98 (0.91-1.05) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | 0 | OR = 0.95 (0.88-1.03) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Payment source % other-pay (per 10 unit increase) | 0 | OR = 0.94 (0.87-1.01) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | 0 | OR = 0.97 (0.89-1.05) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Presence of a RN/LPN | 0 | OR = 0.74 (CI not reported) | use of warfarin or antiplatelets | Previous stroke | Sloane et al. (2004) [13] |
|  | Size ≤ 80 (vs 81-199) | 0 | OR = 1.01 (0.81-1.26) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | 0 | OR = 0.92 (0.77-1.11) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
|  | Size ≥ 200 (vs 81 to 199) | 0 | OR = 1.17 (0.99-1.39) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | 0 | OR = 1.08 (0.90-1.30) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Special care unit | 0 | OR = 1.15 (0.83-1.59) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | + | OR = 1.33 (1.02-1.73) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Staff resources any full-time physicians | - | OR = 0.76 (0.63-0.92) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | 0 | OR = 1.05 (0.89-1.24) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Staff resources (contract) | 0 | OR = 1.04 (0.89-1.20) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | 0 | OR = 1.02 (0.89-1.17) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Staff resources (physician extenders) | + | OR = 1.21 (1.0-1.47) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | 0 | OR = 1.08 (0.87-1.34) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Traditional facility (vs small) | 0 | OR = 0.78 (CI not reported) | use of warfarin or antiplatelets | Previous stroke | Sloane et al. (2004) [13] |
| Â | Weekly physician visits | 0 | OR = 0.94 (CI notreported) | use of warfarin or antiplatelets | Previous stroke | Sloane et al. (2004) [13] |
Gender | Female | 0 | not reported | use of warfarin | AF | Gurwitz et al. (1997) [8] |
| Â | Â | - | OR = 0.94 (0.90-0.98) | use of warfarin orantiplatelets | Previous stroke | Quilliam et al. (2001) [12] |
| Â | Â | 0 | OR = 0.99 (0.87-1.13) | initiate warfarin orantiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | 0 | OR = 1.00 (0.89-1.13) | discontinue warfarinor antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | 0 | OR = 0.81 (CI not reported) | use of warfarin orantiplatelets | Previous stroke | Sloane et al. (2004) [13] |
Physical Function | Substantial mobility | 0 | not reported | use of warfarin | AF | Gurwitz et al. (1997) [8] |
| Â | Mild impairment | 0 | not reported | use of warfarin | AF | Gurwitz et al. (1997) [8] |
| Â | Intermediate mobility | 0 | not reported | use of warfarin | AF | Gurwitz et al. (1997) [8] |
| Â | Moderate impairment | 0 | OR = 0.95 (0.75-1.20) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | 0 | OR = 0.90 (0.70-1.16) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | 0 | not reported | use of warfarin | AF | Gurwitz et al. (1997) [8] |
| Â | Â | 0 | OR = 1.03 (0.95-1.11) | use of warfarin or antiplatelets | Previous stroke | Quilliam et al. (2001) [12] |
| Â | Dependent | - | OR = 0.69 (0.64-0.75) | use of warfarin or antiplatelets | Previous stroke | Quilliam et al. (2001) [12] |
| Â | Â | - | OR = 0.73 (0.56-0.96) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | 0 | OR = 0.99 (0.79-1.25) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | 0 | OR = 1.21 (CI notreported) | use of warfarin or antiplatelets | Previous stroke | Sloane et al. (2004) [13] |
| Â | Severe impairment | 0 | not reported | use of warfarin | AF | Gurwitz et al. (1997) [8] |
Race/ethnicity | American Indian | 0 | OR = 1.00 (0.70-1.43) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | 0 | Difference = -0.8(-8.9 to 7.3) | prevalence difference from non-Hispanic white for receiving warfarin or antiplatelets | Recent ischemic stroke | Christian et al. (2003) [17] |
| Â | Â | 0 | OR = 1.47 (0.98-2.20) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Asian/Pacific islander | 0 | Difference = -5.2 (-18.1 to 7.8) | prevalencedifference from non-Hispanic white for receiving warfarin or antiplatelets | Recentischemicstroke | Christian et al. (2003) [17] |
| Â | Â | 0 | OR = 0.71 (0.42-1.21) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | - | OR = 0.44 (0.23-0.83) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Black | - | OR = 0.80 (0.75-0.85) | use of warfarin or antiplatelets | Previous stroke | Quilliam et al. (2001) [12] |
| Â | Hispanic | 0 | Difference = - 7.6 (-17.6 to 2.2) | prevalence difference from non-Hispanic white for receiving warfarin or antiplatelets | Recent ischemic stroke | Christian et al. (2003) [17] |
| Â | Â | 0 | OR = 0.81 (0.51-1.29) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | 0 | OR = 1.01 (0.62-1.65) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Non- Hispanic black | - | OR = 0.62 (0.49-0.78) | initiate warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | 0 | OR = 1.03 (0.86-1.24) | discontinue warfarin or antiplatelets | Previous stroke | Hughes et al. (2004) [18] |
| Â | Â | - | Difference = - 7.6 (-11.2 to -3.9) | prevalence difference from non-Hispanic white for receiving warfarin or antiplatelets | Recent ischemic stroke | Christian et al. (2003) [17] |
| Â | Other | 0 | OR = 0.95 (0.86-1.04) | use of warfarin or antiplatelets | Previous stroke | Quilliam et al. (2001) [12] |
| Â | White | 0 | OR = 0.69 (CI not reported) | use of warfarin or antiplatelets | Previous stroke | Sloane et al. (2004) [13] |
Stroke risk | 1 risk factor | 0 | OR = 1.44 (0.52-4.03) | use of warfarin | AF | McCormick et al. (2001) [11] |
| Â | 2 risk factors | 0 | OR = 2.44 (0.93-6.39) | use of warfarin | AF | McCormick et al. (2001) [11] |
| Â | 3 risk factors | 0 | OR = 2.37 (0.90-6.20) | use of warfarin | AF | McCormick et al. (2001) [11] |
|  | ≥ 4 risk factors | 0 | OR = 2.50 (0.90-6.95) | use of warfarin | AF | McCormick et al. (2001) [11] |
| Â | High risk | 0 | OR = 1.49 (0.93-2.36) | use of warfarin | AF | Lau et al. (2004)[10] |