An Evaluation of Intravenous Vitamin K for Warfarin Reversal: Are Guideline Recommendations Being Followed?

Background: Vitamin K antagonists (eg, warfarin) remain the mainstay of anticoagulation therapy in the United States, with over 22 million prescriptions being filled annually. Unfortunately, warfarin therapy is difficult to manage and increases bleeding risk. The 2012 American College of Chest Physicians guidelines created a warfarin reversal algorithm that suggested the stringent use of intravenous vitamin K. Objective: The purpose of this evaluation was to determine the rates of adherence with guideline recommendations in clinical practice. Method: A convenience sample of 3 months of intravenous vitamin K medication administration data (September to November 2013) was obtained to conduct a retrospective review. Patients with underlying hepatic dysfunction or lack of warfarin therapy were excluded. Vitamin K use was evaluated for consistency with the 2012 guidelines. Results: A total of 364 patients were reviewed and 119 were included. Vitamin K utilization was consistent with guideline recommendations f...