Abstract
Purpose. Results of a comparison of blood product use and cost outcomes with use of 3-factor versus 4-factor prothrombin complex concentrate (PCC) for indications other than warfarin reversal are presented. Methods. Consecutive patients who received 3-factor PPC (PCC3) or 4-factor PCC (PCC4) for non–warfarin-related indications at 2 U.S. hospitals during a 19-month period were identified. The primary outcome was in-hospital blood product use, with a focus on plasma use. Total hemostasis costs, intensive care unit (ICU) and hospital lengths of stay, and other outcomes were evaluated. Results. Indications for PCC3 use (n = 118) or PCC4 use (n = 64) included intraoperative bleeding, nonintraoperative bleeding, coagulopathy of liver disease, and reversal of direct-acting oral anticoagulant effects. The proportion of patients who received plasma was 56.8% with PCC3 use versus 53.1% with PCC4 use (p = 0.643); the corresponding median volumes of plasma received were 638 mL (interquartile range [IQR], 550–1,355 mL) and 656 mL (IQR, 532–1,136 mL), respectively. The median total hemostasis costs were $5,559 (IQR, $3,922–$8,159) with PCC3 use and $7,771 (IQR, $6,366–$9,205) with PCC4 use (p < 0.001). Conclusion. PCC3 use and PCC4 use were associated with similar blood product use, ICU length of stay, hospital length of stay, and in-hospital mortality when given for non–warfarin-related indications. However, relative to PCC3 use, PCC4 use was associated with an increase in costs that was primarily due to drug costs.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1103-1109 |
| Number of pages | 7 |
| Journal | American Journal of Health-System Pharmacy |
| Volume | 75 |
| Issue number | 15 |
| DOIs | |
| State | Published - Aug 1 2018 |
Fingerprint
Keywords
- Anticoagulants
- Blood coagulation disorders
- Blood coagulation factors
- Hemorrhage
- Injuries
- Wounds
ASJC Scopus subject areas
- Pharmacology
- Health Policy
Cite this
Comparison of blood product use and costs with use of 3-factor versus 4-factor prothrombin complex concentrate for off-label indications. / DeAngelo, Jessica; Jarrell, Daniel H.; Cosgrove, Richard; Camamo, James; Edwards, Christopher J.; Patanwala, Asad E.
In: American Journal of Health-System Pharmacy, Vol. 75, No. 15, 01.08.2018, p. 1103-1109.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Comparison of blood product use and costs with use of 3-factor versus 4-factor prothrombin complex concentrate for off-label indications
AU - DeAngelo, Jessica
AU - Jarrell, Daniel H.
AU - Cosgrove, Richard
AU - Camamo, James
AU - Edwards, Christopher J.
AU - Patanwala, Asad E
PY - 2018/8/1
Y1 - 2018/8/1
N2 - Purpose. Results of a comparison of blood product use and cost outcomes with use of 3-factor versus 4-factor prothrombin complex concentrate (PCC) for indications other than warfarin reversal are presented. Methods. Consecutive patients who received 3-factor PPC (PCC3) or 4-factor PCC (PCC4) for non–warfarin-related indications at 2 U.S. hospitals during a 19-month period were identified. The primary outcome was in-hospital blood product use, with a focus on plasma use. Total hemostasis costs, intensive care unit (ICU) and hospital lengths of stay, and other outcomes were evaluated. Results. Indications for PCC3 use (n = 118) or PCC4 use (n = 64) included intraoperative bleeding, nonintraoperative bleeding, coagulopathy of liver disease, and reversal of direct-acting oral anticoagulant effects. The proportion of patients who received plasma was 56.8% with PCC3 use versus 53.1% with PCC4 use (p = 0.643); the corresponding median volumes of plasma received were 638 mL (interquartile range [IQR], 550–1,355 mL) and 656 mL (IQR, 532–1,136 mL), respectively. The median total hemostasis costs were $5,559 (IQR, $3,922–$8,159) with PCC3 use and $7,771 (IQR, $6,366–$9,205) with PCC4 use (p < 0.001). Conclusion. PCC3 use and PCC4 use were associated with similar blood product use, ICU length of stay, hospital length of stay, and in-hospital mortality when given for non–warfarin-related indications. However, relative to PCC3 use, PCC4 use was associated with an increase in costs that was primarily due to drug costs.
AB - Purpose. Results of a comparison of blood product use and cost outcomes with use of 3-factor versus 4-factor prothrombin complex concentrate (PCC) for indications other than warfarin reversal are presented. Methods. Consecutive patients who received 3-factor PPC (PCC3) or 4-factor PCC (PCC4) for non–warfarin-related indications at 2 U.S. hospitals during a 19-month period were identified. The primary outcome was in-hospital blood product use, with a focus on plasma use. Total hemostasis costs, intensive care unit (ICU) and hospital lengths of stay, and other outcomes were evaluated. Results. Indications for PCC3 use (n = 118) or PCC4 use (n = 64) included intraoperative bleeding, nonintraoperative bleeding, coagulopathy of liver disease, and reversal of direct-acting oral anticoagulant effects. The proportion of patients who received plasma was 56.8% with PCC3 use versus 53.1% with PCC4 use (p = 0.643); the corresponding median volumes of plasma received were 638 mL (interquartile range [IQR], 550–1,355 mL) and 656 mL (IQR, 532–1,136 mL), respectively. The median total hemostasis costs were $5,559 (IQR, $3,922–$8,159) with PCC3 use and $7,771 (IQR, $6,366–$9,205) with PCC4 use (p < 0.001). Conclusion. PCC3 use and PCC4 use were associated with similar blood product use, ICU length of stay, hospital length of stay, and in-hospital mortality when given for non–warfarin-related indications. However, relative to PCC3 use, PCC4 use was associated with an increase in costs that was primarily due to drug costs.
KW - Anticoagulants
KW - Blood coagulation disorders
KW - Blood coagulation factors
KW - Hemorrhage
KW - Injuries
KW - Wounds
UR - http://www.scopus.com/inward/record.url?scp=85052758430&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85052758430&partnerID=8YFLogxK
U2 - 10.2146/ajhp180076
DO - 10.2146/ajhp180076
M3 - Article
C2 - 29941507
AN - SCOPUS:85052758430
VL - 75
SP - 1103
EP - 1109
JO - American Journal of Health-System Pharmacy
JF - American Journal of Health-System Pharmacy
SN - 1079-2082
IS - 15
ER -