Abstract Number: PB0236
Meeting: ISTH 2020 Congress
Background: 4F-PCC is commonly used in non-VKA anticoagulated patients. The clinical efficacy of this practice is still in question.
Aims: Retrospective assessment of the efficacy of 4F-PCC in non-VKA-anticoagulated patients within our emergency department (ED).
Methods: Data of patients who were given 4F-PCC upon admission to the ED over a 3-year period were collected and evaluated for VKA-treated (group A) and non-VKA-treated patients (group B). Changes in INR, bleeding events, and clinical outcome were assessed in both groups.
Results: Over 3 years, 147 patients received 4F-PCC at time of ED admission, of whom 71% (n=105) were from group A and 29% (n=42) were from group B. Vitamin-K was administered in 17 (16%) of group A patients and 8 (19%) of group B patients. The most common reason for 4F-PCC administration in both groups was correction of INR (67% and 71%, respectively). Bleeding at time of admission was less common in both groups (33% and 29%, respectively). A significant correction of INR was observed in group A (3.5±1.9 to 1.4±0.3, p< 0.05) but no significant changes were detected in group B (1.9±1.1 to 1.6±1.2, p=0.78). Bleeding was significantly controlled in group A patients over the first 24 hours (94% vs. 17%). Four patients (33%) died within 24 hours of admission in group B vs 2 patients (6%) in group A. No thrombotic events were reported in either group.
Conclusions: Our data showed that almost one third of patients treated with 4F-PCC are non-VKA treated patients. As expected, significant changes in INR were detected in the VKA-treated patients but not in the non-VKA-treated patients. A 24-hour assessment of bleeding and clinical outcomes revealed better responses in the VKA-treated patients. Although we report no direct adverse effects as a result of administration of 4F-PCC in our non-VKA-treated patients, no significant clinical benefits were detected either.
To cite this abstract in AMA style:McRae H, Kara F, Baum R, Acquisto N, Refaai M. Assessment of Four Factor Prothrombin Complex Concentrate (4F-PCC) Usage in Emergency Department Patients: A Single Center Experience [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/assessment-of-four-factor-prothrombin-complex-concentrate-4f-pcc-usage-in-emergency-department-patients-a-single-center-experience/. Accessed January 23, 2022.
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