Abstract
Background
Prothrombin complex concentrate (PCC) is used as an alternative to fresh frozen plasma
(FFP) for emergency bleeding. The primary objective of this study was to compare the
time from order to start of administration between 3-factor PCC (PCC3), 4-factor (PCC4),
and FFP in the emergency department (ED). The secondary objective was to evaluate
the effect of an ED pharmacist on time to administration of PCCs.
Methods
This was a single center three-arm retrospective cohort study. Adult patients in the
ED with bleeding were included. The primary outcome measure was the time from order
to administration, which was compared between PCC3, PCC4, and FFP. The time from order
to administration was also compared when the ED pharmacist was involved versus not
involved in the care of patients receiving PCC.
Results
There were 90 patients included in the study cohort (30 in each group). The median
age was 69 years (IQR 57–82 years), and 57% (n = 52) were male. The median time from order to administration was 36 min (IQR 20–58 min) for PCC3, 34 min (IQR 18–48 min) for PCC4, and 92 min (IQR 63–133) for FFP (PCC3 versus PCC4, p = 0.429; PCC3 versus FFP, p < 0.001; PCC4 versus FFP, p < 0.001). The median time from order to administration was significantly decreased when
the ED pharmacist was involved (24 min [IQR 15–35 min] versus 42 min [IQR 32–59 min], p < 0.001).
Conclusions
Time from order to administration is faster with PCC than FFP. ED pharmacist involvement
decreases the time from order to administration of PCC.
Abbreviations:
ED (emergency department), FFP (fresh frozen plasma), ICU (intensive care unit), MTP (massive transfusion protocol), PCC (prothrombin complex concentrate), PCC3 (3-factor PCC), PCC4 (4-factor PCC)Keywords
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Article Info
Publication History
Published online: March 26, 2018
Accepted:
March 23,
2018
Received in revised form:
March 22,
2018
Received:
January 9,
2018
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
