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Vulnerability to Warfarin: Could Undernutrition Be a Predictor?

Anthea B. Lehmann, MD, MRCP
Arch Intern Med. 1997;157(12):1385. doi:10.1001/archinte.1997.00440330129015.
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A question that the Stroke Prevention in Atrial Fibrillation Investigators1 could answer with their data is whether the elderly patients taking warfarin sodium who suffered intracranial hemorrhage had a mean body mass index that was significantly lower than the elderly patients taking warfarin who did not bleed. The association between an age older than 75 years and the risk for a major hemorrhage while taking warfarin was confirmed of course in the secondary prevention trial.2 It is not clear from the article whether body mass index was one of the baseline characteristics tested against warfarin-related major hemorrhage and, if it was or was not, this should be stated since it is clearly of interest.

Undernutrition is very common in elderly, hospitalized patients, and as total energy intake decreases, there is usually a failure to compensate by increased nutrient density, in particular with vitamin K—containing plants. This area has


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