The International Normalized Ratio (INR) calculator is a simple, free tool to assess the unified prothrombin time (PT), and its meaning. It's an easy way to evaluate both the extrinsic pathway and the common pathway of coagulation.
If you'd like to find out what is the INR normal range and how to calculate it, or discover why your INR results are so important - read on! 🧮
What does INR measure?
In general, INR informs us about blood's ability to clot. It is used to measure liver function, effects of certain drugs (warfarin and other older anticoagulants), and the levels of vitamin K.
INR (International Normalized Ratio) is an analytic calculation created to unify the prothrombin time (PT) acquired in different laboratories using different reagents. To put it simply: because of the creation of INR, all Polish, American, and Chinese doctors can talk about the PTs of their patients together without getting confused with its various values.
To be precise, INR describes both the extrinsic pathway and common pathway of coagulation, that is, it allows us to measure the levels of different clotting factors, enumerated below:
- Extrinsic pathway:
- VII (proconvertin).
- Common pathway:
- I (fibrinogen);
- II (prothrombin);
- V (proaccelerin); and
- X (Stuart–Prower factor).
Other methods used to measure the clotting of the blood are:
INR result meaning
The higher the INR, the longer it takes for the blood to clot. Elevated INR may inform us of an increased risk of bleeding, while low INR can mean a possibility of thromboembolism complications.
- A PT INR test is a simple and efficient way of controlling the treatment of people that suffer from atrial fibrillation, mechanical heart valves, thromboembolism, stroke, or any disease of the peripheral arteries:
- INR < 1.1 - the average level for a healthy person, who not currently being treated with any anticoagulation drugs;
- 1.1 < INR < 2.0 - an elevated level of INR, not yet sufficient to diagnose patient being treated with anticoagulation drugs. A possible sign of a liver insufficiency;
- 2.0 ≤ INR ≤ 3.0 - the therapeutic level for people treated with warfarin & other, older types of anticoagulants; and
- INR > 3.0 - the INR is too high and may pose the risk of excessive bleeding❗ This level of INR might be recommended for people who have the older generation of artificial heart valve.
- Other reasons for higher INR:
- Inherited or acquired disease that causes the deficiency of one of the clotting factors (I, II, V, VII, X);
- Disseminated intravascular coagulation (DIC);
- Depletion/insufficient intake of vitamin K; and
- Destruction of the liver, caused by, e.g., cirrhosis.
💡 Anticoagulants are drugs designed to slow down the clotting of the blood. Their effect is shown by an increased PT or INR. New oral anticoagulants, such as dabigatran, do not require regular check-ups and blood tests, making them more comfortable to use.
We always need to think about the possible complications & benefits connected to any treatment. To assess the risk of diseases that should be treated with anticoagulants, we can use one of the tools enumerated below:
Risk of thromboembolism:
Risk of pulmonary embolism:
How to use the INR calculator?
Our INR calculator needs three types of data:
- The patient's prothrombin time (PT) in seconds; PT is one of the standard blood tests performed for the assessment of blood clotting.
- The PT of the control, standard sample used in your local diagnostic center, in seconds; and
- The ISI (International Sensitivity Index) value, determined by a given manufacturer. It measures the sensitivity of the tissue factor used in the PT analytic process.
Or INR calculator will perform a quick INR check, and display the significance of your results.
How to calculate INR from PT?
The equation used in our INR calculator looks as follows:
INR = (Patient's PT / Control PT)ISI
ISI usually takes the values of 0.9-1.7. Both control PT and ISI depend on the analytical method used, and should be well known and distributed by your local laboratory.
The INR test should be performed in case of any suspicion of a coagulation defect. It is also crucial to know your patient's INR/PT status before any non-elective surgery.