Four-factor Prothrombin Complex Concentrate for Reversal of Factor Xa Inhibitors versus Warfarin in Life-threatening Bleeding
INTRODUCTION: Factor Xa (fXa) inhibitor reversal for life-threatening bleeding is controversial due to a lack of high-quality evidence. The purpose of this study was to determine the hemostatic efficacy of four-factor prothrombin complex concentrate (4F-PCC) for the reversal of fXa inhibitors compared to warfarin for life-threatening bleeding.
METHODS: This was a multicenter, retrospective cohort study at two academic medical centers between January 1, 2014-December 31, 2019, which included patients who presented to the emergency department with a life-threatening bleed necessitating anticoagulation reversal with 4F-PCC. The primary endpoint was achievement of hemostatic efficacy after 4F-PCC administration.
RESULTS: Of the 525 patients who had an order for 4F-PCC during the study period, 148 patients met the criteria for inclusion (n = 48 fXa inhibitor group; n = 100 warfarin group). Apixaban (52.1%) and rivaroxaban (45.8%) were the most commonly used fXa inhibitors. Effective hemostasis was similar between groups (79.2% fXa inhibitor group vs 85% warfarin group, p = 0.38). This was consistent across all types of bleeding. Thrombotic events were rare in both groups (2% vs 3%).
CONCLUSION: This multicenter, retrospective cohort study demonstrated that using 4F-PCC for treatment of life-threatening bleeding produced effective hemostasis in patients on fXa inhibitors and warfarin.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:22 |
|---|---|
| Enthalten in: |
The western journal of emergency medicine - 22(2021), 2 vom: 26. Feb., Seite 163-169 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Rech, Megan A [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
37224-63-8 |
|---|
| Anmerkungen: |
Date Completed 30.06.2021 Date Revised 02.04.2022 published: Electronic Citation Status MEDLINE |
|---|
| doi: |
10.5811/westjem.2020.11.47931 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM32411088X |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM32411088X | ||
| 003 | DE-627 | ||
| 005 | 20231225185624.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.5811/westjem.2020.11.47931 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1080.xml |
| 035 | |a (DE-627)NLM32411088X | ||
| 035 | |a (NLM)33856296 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Rech, Megan A |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Four-factor Prothrombin Complex Concentrate for Reversal of Factor Xa Inhibitors versus Warfarin in Life-threatening Bleeding |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 30.06.2021 | ||
| 500 | |a Date Revised 02.04.2022 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a INTRODUCTION: Factor Xa (fXa) inhibitor reversal for life-threatening bleeding is controversial due to a lack of high-quality evidence. The purpose of this study was to determine the hemostatic efficacy of four-factor prothrombin complex concentrate (4F-PCC) for the reversal of fXa inhibitors compared to warfarin for life-threatening bleeding | ||
| 520 | |a METHODS: This was a multicenter, retrospective cohort study at two academic medical centers between January 1, 2014-December 31, 2019, which included patients who presented to the emergency department with a life-threatening bleed necessitating anticoagulation reversal with 4F-PCC. The primary endpoint was achievement of hemostatic efficacy after 4F-PCC administration | ||
| 520 | |a RESULTS: Of the 525 patients who had an order for 4F-PCC during the study period, 148 patients met the criteria for inclusion (n = 48 fXa inhibitor group; n = 100 warfarin group). Apixaban (52.1%) and rivaroxaban (45.8%) were the most commonly used fXa inhibitors. Effective hemostasis was similar between groups (79.2% fXa inhibitor group vs 85% warfarin group, p = 0.38). This was consistent across all types of bleeding. Thrombotic events were rare in both groups (2% vs 3%) | ||
| 520 | |a CONCLUSION: This multicenter, retrospective cohort study demonstrated that using 4F-PCC for treatment of life-threatening bleeding produced effective hemostasis in patients on fXa inhibitors and warfarin | ||
| 650 | 4 | |a Journal Article | |
| 650 | 7 | |a Anticoagulants |2 NLM | |
| 650 | 7 | |a Blood Coagulation Factors |2 NLM | |
| 650 | 7 | |a Factor Xa Inhibitors |2 NLM | |
| 650 | 7 | |a Pyrazoles |2 NLM | |
| 650 | 7 | |a Pyridones |2 NLM | |
| 650 | 7 | |a prothrombin complex concentrates |2 NLM | |
| 650 | 7 | |a 37224-63-8 |2 NLM | |
| 650 | 7 | |a apixaban |2 NLM | |
| 650 | 7 | |a 3Z9Y7UWC1J |2 NLM | |
| 650 | 7 | |a Warfarin |2 NLM | |
| 650 | 7 | |a 5Q7ZVV76EI |2 NLM | |
| 700 | 1 | |a Masic, Dalila |e verfasserin |4 aut | |
| 700 | 1 | |a Hammond, Drayton A |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The western journal of emergency medicine |d 2007 |g 22(2021), 2 vom: 26. Feb., Seite 163-169 |w (DE-627)NLM189618582 |x 1936-9018 |7 nnns |
| 773 | 1 | 8 | |g volume:22 |g year:2021 |g number:2 |g day:26 |g month:02 |g pages:163-169 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.5811/westjem.2020.11.47931 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 22 |j 2021 |e 2 |b 26 |c 02 |h 163-169 | ||