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Retrospective review of a Prothrombin Complex Concentrate (Beriplex P/N) for the management of perioperative bleeding unrelated to oral anticoagulation

Chowdary, Pratima, Tang, Augustine, Watson, Dale, Besser, Martin, Collins, Peter, Creagh, Michael Desmond, Qureshi, Hafiz, Rokicka, Margaret, Nokes, Tim, Diprose, Paul and Gill, Ravi 2018. Retrospective review of a Prothrombin Complex Concentrate (Beriplex P/N) for the management of perioperative bleeding unrelated to oral anticoagulation. Clinical and Applied Thrombosis/Hemostasis 24 (7) , pp. 1159-1169. 10.1177/1076029617753537

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Abstract

A multicenter, retrospective, observational study of 4-factor prothrombin complex concentrate (PCC) and/or fresh frozen plasma (FFP) use within routine clinical care unrelated to vitamin K antagonists was conducted. The PCC was administered preprocedure for correction of coagulopathy (prophylactic cohort) and treatment of bleeding postsurgery (treatment cohort). Of the 445 patients included, 40 were in the prophylactic cohort (PCC alone [n ¼ 16], PCC and FFP [n ¼ 5], FFP alone [n ¼ 19]) and 405 were in the treatment cohort (PCC alone [n ¼ 228], PCC and FFP [n ¼ 123], FFP alone [n ¼ 54]). Cardiovascular surgery was the most common setting. PCC doses ranged between 500 and 5000 IU. Effectiveness (assessed retrospectively) was reported as effective in 93.0% in the PCC-only group (95% confidence interval, 89.1% to 95.9%), 78.9% (70.8% to 85.6%) with PCC and FFP, and 86.3% (76.2% to 93.2%) with FFP alone. In the treatment cohort, international normalized ratio was significantly reduced in all 3 groups. In patients who received PCC, the rate of thromboembolic events (1.9%) was below rates in the literature for similar procedures. PCCs offer a potential alternative to FFP in the management of perioperative bleeding unrelated to oral anticoagulant therapy.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Publisher: SAGE Publications
ISSN: 1076-0296
Date of First Compliant Deposit: 20 March 2018
Date of Acceptance: 30 October 2017
Last Modified: 22 Oct 2018 13:12
URI: http://orca.cf.ac.uk/id/eprint/110052

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