Evaluation of 4-factor prothrombin complex concentrate (PCC) in hospitalized patients

Purpose: In 2014, Gwinnett Medical Center (GMC) developed reversal guidelines to assist physicians in selection of reversal agents for all available oral and parenteral anticoagulants. The objective of this study is to evaluate whether 4-factor PCC usage was appropriately designated for patients experiencing acute bleeds or preparing for invasive procedures within the study institution. Methods: This study was approved by the study institution’s Institutional Review Boards. The study group included all patients who received 4-factor PCC at the institution to date. A retrospective chart review was performed on these patients to complete the evaluation. This data was evaluated as appropriate or non-appropriate based on the study institution’s developed protocol for anticoagulant reversal. Results: A report was generated of 36 patients who had received PCC from October 1, 2014 to October 28, 2015. Based on the chart review, we conclude that 4-factor PCC was appropriately indicated in 91.7% of the cases. PCC was correctly dosed in 83.3% of total patients included in the review. Conclusion: Overall, we conclude 4-factor PCC is being used appropriately according to the protocol in the majority of patients in the institution based on correct indication and dosing. We recommend adding reversal agents for each individual NOAC for appropriate indications as they become FDA approved