caa a22 4500 445825464 CHVBK 20180317145257.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1007/s00246-011-9984-x doi (NATIONALLICENCE)springer-10.1007/s00246-011-9984-x Management of Warfarin in Children With Heart Disease [Elektronische Daten] [William Mahle, Scott Simpson, Paulette Fye, Michael McConnell] Warfarin is an important therapy for children with heart disease. We assessed the impact of a computerized warfarin-dosing software program on measured INR values using a historical case-control design. Children (infant to 20years of age) with cardiac disease managed with warfarin between September 1, 2006, and August 31, 2009 were included in the analysis. Warfarin therapy was tailored to specific underlying conditions based on consensus guidelines. Before the use of dosing software, medication adjustments were made by physicians using published guidelines. After software implementation, dosing adjustments were based on the software algorithm. There were 86 subjects in this analysis, and the most common indication for warfarin was prosthetic valve. Overall, the incidence of adverse bleeding events was 1.3% per patient-year. An analysis of patient-related factors associated with a low percentage of time within goal range demonstrated that both female sex (P=0.048) and nonwhite race (P=0.037) were significantly associated with less time in the target range. Use of the software program was associated with an increase in the percentage of time during which the INR was within the target range from 41.4 to 53.1% (P<0.001). Incorporation of a computerized software program to assist dosing can improve the percentage of time that children with cardiac disease requiring warfarin remain within the target therapeutic range. Strategies to improve management and decrease sex and racial disparities in this population are needed. Springer Science+Business Media, LLC, 2011 Anticoagulation nationallicence Outcomes nationallicence Disparities nationallicence Mahle William Children's Healthcare of Atlanta, Emory University School of Medicine, 1405 Clifton Rd. NE, 30322, Atlanta, GA, USA aut Simpson Scott Children's Healthcare of Atlanta, Emory University School of Medicine, 1405 Clifton Rd. NE, 30322, Atlanta, GA, USA aut Fye Paulette Children's Healthcare of Atlanta, Emory University School of Medicine, 1405 Clifton Rd. NE, 30322, Atlanta, GA, USA aut McConnell Michael Children's Healthcare of Atlanta, Emory University School of Medicine, 1405 Clifton Rd. NE, 30322, Atlanta, GA, USA aut Pediatric Cardiology Springer-Verlag 32/8(2011-12-01), 1115-1119 0172-0643 32:8<1115 2011 32 246 https://doi.org/10.1007/s00246-011-9984-x text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00246-011-9984-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Mahle William Children's Healthcare of Atlanta, Emory University School of Medicine, 1405 Clifton Rd. NE, 30322, Atlanta, GA, USA aut NATIONALLICENCE 700 1- Simpson Scott Children's Healthcare of Atlanta, Emory University School of Medicine, 1405 Clifton Rd. NE, 30322, Atlanta, GA, USA aut NATIONALLICENCE 700 1- Fye Paulette Children's Healthcare of Atlanta, Emory University School of Medicine, 1405 Clifton Rd. NE, 30322, Atlanta, GA, USA aut NATIONALLICENCE 700 1- McConnell Michael Children's Healthcare of Atlanta, Emory University School of Medicine, 1405 Clifton Rd. NE, 30322, Atlanta, GA, USA aut NATIONALLICENCE 773 0- Pediatric Cardiology Springer-Verlag 32/8(2011-12-01), 1115-1119 0172-0643 32:8<1115 2011 32 246 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer