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논문 기본 정보

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학술저널
저자정보
Zaina Naeem (Department of Emergency Medicine Renaissance School of Medicine at Stony Brook University) Salsabeel Allan (Department of Emergency Medicine Renaissance School of Medicine at Stony Brook University) Aneury Hernandez (Department of Emergency Medicine Renaissance School of Medicine at Stony Brook University) Dennis K Galanakis (Department of Pathology Renaissance School of Medicine at Stony Brook University) Adam J. Singer (Department of Emergency Medicine Renaissance School of Medicine at Stony Brook University)
저널정보
대한응급의학회 Clinical and Experimental Emergency Medicine Clinical and Experimental Emergency Medicine Vol.8 No.2
발행연도
2021.1
수록면
75 - 81 (7page)

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Objective Four-factor prothrombin complex concentrate (4F-PCC) was approved by the US Food and Drug Administration in 2013 for management of severely bleeding patients on warfarin therapy. We describe use of 4F-PCC at a large, suburban academic center. Methods We retrospectively reviewed all patients receiving 4F-PCC from its introduction through 2016 at a large level 1 trauma center. Clinical and demographic data were obtained, including indications for anticoagulation and antiplatelet agents, comorbidities, concomitant medications, etiology and site of bleeding, as well as disposition, length of stay, mortality, and thrombotic events. Results One hundred eighty-four patients received 4F-PCC. Mean age was 72 years; 40.8% were female. Indications for 4F-PCC administration included: active bleeding (74%), reversal prior to a procedure (14%), and elevated international normalized ratio (12%). Warfarin was the most common concomitant medication (71.1%). Most patients were receiving anticoagulation for atrial fibrillation (63%). Concomitant treatments for bleeding included vitamin K (58.2%), packed red blood cells (50%), fresh frozen plasma (38%), and platelets (26.1%), amongst others. Median length of hospital stay was 8.4 days. Nine patients (4.9%) developed thrombosis within 90 days of 4F-PCC. Mortality was 24.5%, with notably higher rates amongst those who received 4F-PCC for off-label indications (19.1% on-label mortality vs. 37.7% off-label mortality on chi-square analysis, P=0.01). Conclusion This study demonstrates that 4F-PCC is being utilized for indications other than the reversal of warfarin-induced coagulopathy. Further investigation is warranted to determine the efficacy and safety of 4F-PCC for these potential indications.
#Prothrombin complex concentrate #Anticoagulants #Blood coagulation factors #Vitamin K

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참고문헌 (21)

참고문헌 신청
Holt T / 2018 / Three-versus four-factor prothrombin complex concentrate for the reversal of warfarin-induced bleeding / Int J Crit Illn Inj Sci 8:36~40 google schola Levine MN / 2001 / Hemorrhagic complications of anticoagulant treatment / Chest 119(1 Suppl):108S~121S google schola Wysowski DK / 2007 / Bleeding complications with warfarin use : a prevalent adverse effect resulting in regulatory action / Arch Intern Med 167:1414~1419 google schola Klein L / 2015 / Evaluation of fixed dose 4-factor prothrombin complex concentrate for emergent warfarin reversal / Am J Emerg Med 33:1213~1218 google schola Frumkin K / 2013 / Rapid reversal of warfarin-associated hemorrhage in the emergency department by prothrombin complex concentrates / Ann Emerg Med 62:616~626 google schola

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