NDLI: Analysis of inpatient use of fresh frozen plasma and other therapies and associated outcomes in patients with major bleeds from vitamin K antagonism.

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Analysis of inpatient use of fresh frozen plasma and other therapies and associated outcomes in patients with major bleeds from vitamin K antagonism.

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Analysis of inpatient use of fresh frozen plasma and other therapies and associated outcomes in patients with major bleeds from vitamin K antagonism.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Magee, Glenn Peters, Christian Zbrozek, Art
Description	Author Affiliation: Magee G ( Premier Research Services, Charlotte, North Carolina. Electronic address: Glenn_Magee@PremierInc.com.)
Abstract	OBJECTIVE: We conducted an observational study of outcomes and costs associated with fresh frozen plasma (FFP) use in patients receiving warfarin with intracerebral, gastrointestinal, or musculoskeletal bleeding. METHODS: Patients who had at least 1 International Classification of Diseases, Ninth Revision code indicative of anticoagulation history, received ≥ 1 unit FFP, and had patient costs >\$0 were identified from a database of >600 US hospitals. The main outcome was transfusion of additional blood products (eg, cryoprecipitate, red blood cells, or platelets) or vitamin K. Further outcomes included administration of other bleeding-related therapies (eg, recombinant activated factor VII, albumin, or crystalloids), incidence of fluid overload, days in the intensive care unit, discharge status, and total hospital costs. RESULTS: The most frequently administered products were vitamin K and red blood cells, given to 55.6% to 61.0% and 19.2% to 29.3% of patients, respectively. The number of FFP units transfused correlated highly with fluid overload (r > 0.91) and was associated with inpatient mortality, nonhome discharge, and intensive care unit admittance. For both inpatient mortality and nonhome discharge, the odds ratio was significant when ≥ 4 units FFP were transfused (P < 0.05). A dose of >2 units FFP was associated with an increased probability of an intensive care unit stay (P < 0.05). Total costs were greater among patients receiving >2 units FFP compared with patients who received 1 unit FFP (P < 0.001), with a substantial increase in costs incurred when ≥ 4 units FFP were transfused. CONCLUSIONS: In patients with warfarin-related bleeding, inpatient mortality, nonhome discharge, intensive care unit admission, and hospital costs were associated with the number of units of FFP transfused.
File Format	HTM / HTML
ISSN	01492918
Issue Number	9
Volume Number	35
e-ISSN	1879114X
Journal	Clinical Therapeutics
Language	English
Publisher	Elsevier
Publisher Date	2013-09-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Pharmacology Anticoagulants Adverse Effects Blood Component Transfusion Hemorrhage Chemically Induced Therapy Plasma Warfarin Aged Aged, 80 And Over Databases, Factual Female Mortality Hospital Costs Hospitalization Humans Intensive Care Units Male Middle Aged Treatment Outcome Journal Article Observational Study
Content Type	Text
Resource Type	Article
Subject	Pharmacology Pharmacology (medical)

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