Effect of PCC on outcomes of severe traumatic brain injury patients on preinjury anticoagulation

Sai Krishna Bhogadi, Adam Nelson, Hamidreza Hosseinpour, Tanya Anand, Omar Hejazi, Christina Colosimo, Audrey L. Spencer, Michael Ditillo, Louis J. Magnotti, Bellal Joseph

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: This study aims to evaluate effect of 4-factor PCC on outcomes of severe TBI patients on preinjury anticoagulants undergoing craniotomy/craniectomy. Methods: In this analysis of 2018–2020 ACS-TQIP, patients with isolated blunt severe TBI (Head-AIS≥3, nonhead-AIS<2) using preinjury anticoagulants who underwent craniotomy/craniectomy were identified and stratified into PCC and No-PCC groups. Outcomes were time to surgery and mortality. Multivariable binary logistic and linear regression analyses were performed. Results: 1598 patients were identified (PCC-107[7 %], No-PCC-1491[93 %]). Mean age was 74(11) years, 65 % were male, median head AIS was 4. Median time to PCC administration was 109 ​min. On univariable analysis, PCC group had shorter time to surgery (PCC-341, No-PCC-620 ​min, p ​= ​0.002), but higher mortality (PCC35 %, No-PCC21 %,p ​= ​0.001). On regression analysis, PCC was independently associated with shorter time to surgery (β ​= ​−1934,95 %CI ​= ​−3339to-26), but not mortality (aOR ​= ​0.70,95 %CI ​= ​0.14–3.62). Conclusion: PCC may be a safe adjunct for urgent reversal of coagulopathy in TBI patients using preinjury anticoagulants.

Original languageEnglish (US)
Pages (from-to)138-141
Number of pages4
JournalAmerican journal of surgery
Volume232
DOIs
StateAccepted/In press - 2024
Externally publishedYes

Keywords

  • Craniectomy
  • Craniotomy
  • PCC
  • Time to surgery

ASJC Scopus subject areas

  • Surgery

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