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{
    "pk": 13843,
    "title": "Four-factor Prothrombin Complex Concentrate for Reversal of Factor Xa Inhibitors versus Warfarin in Life-threatening Bleeding",
    "subtitle": null,
    "abstract": "Introduction:\n 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.\nMethods:\n 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.\nResults:\n 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%). \nConclusion:\n 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.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "four-factor prothrombin complex concentrate, Factor Xa inhibitor, direct oral anticoagulants, warfarin, hemostatic efficacy, thrombosis"
        }
    ],
    "section": "Health Outcomes",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/9gt4f941",
    "frozenauthors": [
        {
            "first_name": "Megan",
            "middle_name": "A.",
            "last_name": "Rech",
            "name_suffix": "",
            "institution": "Loyola University Medical Center, Department of Pharmacy, Maywood, Illinois; Stritch School of Medicine, Loyola University Chicago, Department of Emergency Medicine, Maywood, Illinois",
            "department": "None"
        },
        {
            "first_name": "Dalila",
            "middle_name": "",
            "last_name": "Masic",
            "name_suffix": "",
            "institution": "Loyola University Medical Center, Department of Pharmacy, Maywood, Illinois",
            "department": "None"
        },
        {
            "first_name": "Drayton",
            "middle_name": "A.",
            "last_name": "Hammond",
            "name_suffix": "",
            "institution": "Rush University Medical Center, Department of Pharmacy, Chicago, Illinois; Rush Medical College, Department of Internal Medicine, Chicago, Illinois",
            "department": "None"
        }
    ],
    "date_submitted": "2020-04-28T10:00:42-07:00",
    "date_accepted": "2020-04-28T10:00:42-07:00",
    "date_published": "2021-02-26T12:10:30-08:00",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/13843/galley/7210/download/"
        }
    ]
}