Holt Tara, Taylor Scott, Abraham Prasad, Mcmillian Wesley, Harris Serena, Curtis James, Elder Tai
Department of Pharmacy, IU Health Methodist Hospital, Indianapolis, IN, USA.
Department of Pharmacy, Via Christi Hospitals, Wichita, KS, USA.
Int J Crit Illn Inj Sci. 2018 Jan-Mar;8(1):36-40. doi: 10.4103/IJCIIS.IJCIIS_40_17.
The objective of this study was to evaluate the effectiveness of 3-factor prothrombin complex concentrate (3F-PCC) compared to 4-factor PCC (4F-PCC) in warfarin-associated bleeding.
This multicenter, retrospective, cohort study analyzed data from patients admitted between May 2011 and October 2014 who received PCC for warfarin-associated bleeding. The primary outcome was the rate of international normalized ratio (INR) normalization, defined as an INR ≤1.3, after administration of 3F-PCC compared to 4F-PCC. Other variables of interest included the incidence of additional reversal agents, new thromboembolic events, and mortality.
A total of 134 patients were included in the analysis. The average dose of PCC administered was 24.6 ± 9.3 units/kg versus 36.3 ± 12.8 units/kg in the 3F-PCC and 4F-PCC groups, respectively, < 0.001. Baseline INR in the 3F-PCC and 4F-PCC groups was 3.61 ± 2.3 and 6.87 ± 2.3, respectively < 0.001. 4F-PCC had a higher rate of INR normalization at first INR check post-PCC administration compared to 3F-PCC (84.2% vs. 51.9%, = 0.0001). Thromboembolic events, intensive care unit and hospital length of stay, and mortality were similar among both groups.
The use of 4F-PCC leads to a more significant reduction in INR compared to 3F-PCC though no difference in mortality or length of stay was observed. Thromboembolism rates were similar among both groups.
本研究旨在评估三因子凝血酶原复合物浓缩剂（3F-PCC）与四因子凝血酶原复合物浓缩剂（4F-PCC）相比，在华法林相关出血治疗中的有效性。
这项多中心、回顾性队列研究分析了2011年5月至2014年10月期间因华法林相关出血而接受凝血酶原复合物浓缩剂治疗的患者数据。主要结局是与4F-PCC相比，3F-PCC给药后国际标准化比值（INR）正常化的比率，定义为INR≤1.3。其他感兴趣的变量包括额外使用逆转剂的发生率、新的血栓栓塞事件以及死亡率。
共有134例患者纳入分析。3F-PCC组和4F-PCC组凝血酶原复合物浓缩剂的平均给药剂量分别为24.6±9.3单位/千克和36.3±12.8单位/千克，P<0.001。3F-PCC组和4F-PCC组的基线INR分别为3.61±2.3和6.87±2.3，P<0.001。与3F-PCC相比，4F-PCC在凝血酶原复合物浓缩剂给药后的首次INR检查时INR正常化率更高（84.2%对51.9%，P=0.0001）。两组之间的血栓栓塞事件、重症监护病房住院时间和医院住院时间以及死亡率相似。
与3F-PCC相比，使用4F-PCC能使INR更显著降低，尽管在死亡率或住院时间方面未观察到差异。两组之间的血栓栓塞率相似。
