Effect of medical history on hemostatic recovery after coagulopathy reversal with prothrombin complex concentrate
This study investigated independent relationships between hypertension and hemostatic efficacy and diabetes and hemostatic efficacy. In both cases, hemostatic efficacy was considered at 24 hours after reversal with prothrombin complex concentrate (PCC). This was a secondary analysis of a dataset obtained from a retrospective, multi-center chart review, evaluating all patients who received PCC within the Seton Healthcare Family from October 2013 to March 2015. Detailed patient histories were recorded, along with categorization of on-label for warfarin reversal and off-label for reversal of dabigatran, rivaroxaban, apixaban, or non-anticoagulant coagulopathy. Hemostatic efficacy status (excellent, good, poor, none) was determined from patient medical records, and based on 24-hour surveillance from the start of PCC infusion. No significant relationships were detected between hypertension or diabetes and hemostatic efficacy, after adjusting for medical history of heart failure, sex, and age. Sex was evaluated as a potential effect modifier of these relationships, but no effect modification was observed. Older age (75 years and above) and being male was associated with non-efficacious reversal. On label reversal and history of heart failure was associated with efficacious reversal. Further longitudinal studies are needed to understand the relationship between medical history and hemostatic efficacy, especially studies with sufficient sample sizes. ^
Tabas, Irene, "Effect of medical history on hemostatic recovery after coagulopathy reversal with prothrombin complex concentrate" (2016). Texas Medical Center Dissertations (via ProQuest). AAI10127423.