Association of four-factor prothrombin complex concentrate with subsequent plasma transfusion: A retrospective cohort study

Transfus Med. 2021 Feb;31(1):69-75. doi: 10.1111/tme.12716. Epub 2020 Sep 27.

Abstract

Objective: To assess whether patients prescribed four-factor prothrombin complex concentrate (4FPC) received less plasma during the following 24-hour period than those treated for the same indications who received only plasma.

Introduction: It is unclear whether 4FPC is associated with a reduction in subsequent plasma transfusion. This is important for minimising transfusion-associated risks and for inventory management.

Materials and methods: We retrospectively studied patients treated for bleeding or coagulopathy. Individuals receiving 4FPC were matched by indication to patients treated with only plasma. Blood products received during 24-hour follow up were compared between 4FPC and plasma-only patients.

Results: There was no difference in the number of patients receiving additional plasma (19 (21%) 4FPC patients vs 31 (34%) plasma-only patients, P = .07) nor in the median number of additional plasma units received (0 units for both groups, interquartile range [0, 0] for 4FPC patients vs [0, 1] for plasma-only patients, P = .09). Subgroup analysis comparing patients who received 4FPC for on-label vs off-label indications found no difference in the number of patients receiving plasma nor in the median number of plasma units received.

Conclusion: 4FPC was prescribed to a diverse set of patients, and administration was not associated with reduced plasma transfusion at our institution.

Keywords: coagulation factor concentrate; plasma; transfusion therapy.

MeSH terms

  • Aged
  • Blood Coagulation Disorders / blood
  • Blood Coagulation Disorders / therapy*
  • Blood Coagulation Factors / administration & dosage*
  • Blood Component Transfusion*
  • Female
  • Hemorrhage / blood
  • Hemorrhage / therapy*
  • Humans
  • Male
  • Middle Aged
  • Plasma*
  • Retrospective Studies

Substances

  • Blood Coagulation Factors
  • prothrombin complex concentrates