Factors Affecting Target INR Attainment Among Hospitalized Patients Newly Initiated On Warfarin At Jimma University Medical Center

Abstract

Background: Warfarin is a widely used anticoagulant, particularly in low-income countries, to prevent thromboembolic complications. Achieving and maintaining the target INR range is critical, as deviations increase the risk of thrombosis or bleeding, especially during the initial weeks of therapy and more so in hospitalized patients . This study investigates factors influencing target INR attainment in hospitalized patients newly starting warfarin at Jimma University Medical Center, aiming to improve anticoagulant therapy management and patient outcomes. Objective: To asses factors affecting target INR attainment among inpatients newly initiated on warfarin at JUMC Methods: An institutional-based prospective logtudinal study was conducted from April ,2024 to March ,2025 at Jimma University Medical Center. Data were collected using a structured questionnaire covering sociodemographic, clinical, and laboratory parameters. Binary logistic regression analysis was done to identify factors associated with attaining target INR at discharge. An adjusted odd ratio with their corresponding 95 % confidence interval was computed. A p-value of less than 0.05 was used to declare the statistical significance level. Results: The study found that only 43.4% ( 49 out of 113 ) patients achieved target INR during hospital stay. good warfarin adherence (AOR = 5.88; 95% CI: 1.19 – 24.3) and frequent INR measurement (AOR = 1.47; 95% CI: 1.03-2.04) were associated with target INR attainment during hospital stay. Conclusion: More than half of patients failed to reach target INR levels during hospitalization. Enhancing adherence and frequent monitoring could improve anticoagulation outcomes.