Variables associated with adequate INR reversal in warfarin treated patients receiving 4-factor prothrombin complex concentrate

Dosing of 4-factor prothrombin complex concentrate (4FPCC) in warfarin treated patients generally utilizes international normalized ratio (INR) and patient weight. The recommended maximum dosing for all INR categories is capped at 100 kg weight. Whether this affects INR reversal is unknown. Furtherm...

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Published in:Journal of thrombosis and thrombolysis 2022-08, Vol.54 (2), p.268-275
Main Authors: Kjerengtroen, Sara, Chauv, Stephanie, Hickman, Abby W., Collingridge, Dave S., Fontaine, Gabriel V.
Format: Article
Language:English
Subjects:
Blood transfusion
Cardiology
Dosage
Drug dosages
Hematology
Hemorrhage
Hemostasis
Medicine
Medicine & Public Health
Mortality
Multiple regression analysis
Prothrombin
Warfarin
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Summary:Dosing of 4-factor prothrombin complex concentrate (4FPCC) in warfarin treated patients generally utilizes international normalized ratio (INR) and patient weight. The recommended maximum dosing for all INR categories is capped at 100 kg weight. Whether this affects INR reversal is unknown. Furthermore, characteristics associated with adequate INR reversal need to be further elucidated. This was a multi-center, retrospective cohort study of 186 patients who received 4FPCC for INR reversal in the setting of warfarin-associated hemorrhage or need for emergent INR reversal. Utilizing multiple regression analysis, we evaluated INR reversal, achievement of hemostasis, and 28-day all-cause mortality. A target INR 
ISSN:0929-5305
1573-742X
DOI:10.1007/s11239-022-02646-0