RAT Support Forum 

Posted by: NEIL WILSON ()
Date: 12 November, 2010 12:09PM

recently had a hospital recommendation to keep a patients INR within the range 1.8 - 2.5, this does not seem to possible. Is there a way to do this at present that I am not aware of or is it possible to customize ranges through a future update ?

Posted by: C Rafferty ()
Date: 12 November, 2010 12:53PM

Dear Neil,
1.8-2.5 is not a recognized reference range, so it would not be advisable to use a customized range. RAT does not facilitate this.
All INR treatment recommendations are for at least 2.0 and above
You could either choose 2.0-2.5 or 2-3

The link below gives all the appropriate ranges.
You will see they use 'target INR'
so for example for a target INR of 2.5 is accepted range is 2.0-3.0

Hopes this helps
Colm Rafferty

Posted by: neil wilson ()
Date: 14 November, 2010 09:50AM

yes I realize that this would not be usual but it was a range specifically recommended to us in an elderly lady with af who was prone to falls. I have seen some literature recommending a lower range in the elderly.

Posted by: C Rafferty ()
Date: 14 November, 2010 12:38PM

Hi Neil
You could use 1.5-2.5?
or less useful 2.0-2.5

Colm Rafferty

Posted by: neil wilson ()
Date: 14 November, 2010 02:21PM

We used 1.5 to 2.5 and patient had a non haemorrhagic cerebral infarc shortly after the inr fell from 1.8 to 1.5. Relatives not entirely happy that we, in their view did not monitor the inr correctly as per what was recommended by hospital, although she did get her bloods checked as recommended. It could of course also have been true that if the range we set was 2-2.5 and the patient had a haemorrhagic stroke we might also have been blamed. In hindsight I could have contacted the consultant to see if he would have been happy with any of the available ranges but It might be useful as a workaround if there was a way to highlight either within the rat patient record or on the printout that a patient " has a different recommended inr range"?

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