Role of Prothrombin Complex Concentrates in Reversal of Direct Oral Anticoagulant Effects

Objective:The aim of this study is to evaluate the efficacy and safety of four-factor prothrombin complex concentrate in reversing the anticoagulant effect in patients presenting to the emergency department with bleeding associated with direct oral anticoagulants.Methods: This single-center, retrospective study evaluated the dosage and efficacy of prothrombin complex concentrate in reversing the anticoagulant effect in patients presenting to the emergency department of a tertiary hospital due to bleeding associated with direct oral anticoagulants or due to elevated international normalized ratio prior to an emergency procedural intervention associated with direct oral anticoagulants.Results: Of the 20 participants, 65% were 80 years of age or older.The most common presenting complaints were gastrointestinal and musculoskeletal bleeding.The participants received a total of 34 doses (500 IU/20 mL) of prothrombin complex concentrate, and pre-and post-treatment coagulation test results showed significant improvement.However, no significant relationship was observed between hospital outcome (i.e., death or discharge) and the treatment protocols.Four patients developed thromboembolic events after treatment, and two of these had received more than one prothrombin complex concentrate dose. Conclusion:Four-factor prothrombin complex concentrates are useful adjuncts for the urgent reversal of the direct oral anticoagulants-associated anticoagulant effects, particularly Z Ama: Bu almann amac, yeni nesil oral antikoaglanlara bal kanamalarda drt faktrl protrombin kompleks konsantresinin acil servisteki hastalarda antikoaglan etkisini tersine evirmedeki etkinliini ve gvenliini deerlendirmektir.Yntemler: Bu tek merkezli, retrospektif alma, yeni nesil oral antikoaglanlarla ilikili kanama nedeniyle veya yeni nesil oral antikoaglanlarla ilikili acil prosedrel ilem ncesi uluslararas normalletirilmi oran ykseklii saptanmas zerine nc basamak bir hastanenin acil servisine bavuran hastalarda protrombin kompleks konsantresinin antikoaglan etkisini tersine evirmedeki dozajn