In:
Acta Haematologica, S. Karger AG, Vol. 143, No. 3 ( 2020), p. 266-271
Abstract:
〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Patients treated with direct Xa inhibitors may require urgent surgery. Administration of prothrombin complex concentrate (PCC) in this setting is common; however, it is based on limited experience in healthy volunteers. 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 To characterize the population receiving PCC for apixaban/rivaroxaban reversal prior to an urgent surgery and evaluate its efficacy and safety. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 This was a retrospective study in 2 tertiary hospitals. Bleeding was evaluated based on surgical reports, hemoglobin drop, and the use of blood products or additional PCC during 48 h. Safety measures were thrombotic complications and 30-day mortality. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Sixty-two patients aged 80.7 ± 9 years, treated with apixaban (39.63%) or rivaroxaban (23.37%), received PCC before an urgent surgery/procedure. Most underwent abdominal operation (61%), orthopedic surgery (13%), or transhepatic cholecystostomy insertion (10%). Bleeding during surgery was reported in 3 patients (5%), no patient required additional PCC, and 16 patients (26%) received packed cells (median: 1 unit, range: 1–5). The 30-day mortality and thrombosis rates were 21% ( 〈 i 〉 n 〈 /i 〉 = 13) and 3% ( 〈 i 〉 n 〈 /i 〉 = 2), respectively. The cause of death was related to the primary disease, most commonly sepsis. No patient died due to bleeding/thrombosis. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Our results support the use of PCC to achieve hemostasis in patients treated with Xa inhibitors prior to an urgent surgery.
Type of Medium:
Online Resource
ISSN:
0001-5792
,
1421-9662
Language:
English
Publisher:
S. Karger AG
Publication Date:
2020
detail.hit.zdb_id:
1481888-7
detail.hit.zdb_id:
80008-9
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