UMEM Educational Pearls

  • A feared complication of patients taking vitamin K antagonists (VKA) is life-threatening bleeding (LTB), including intracranial hemorrhage (ICH).
  • Prothrombin complex concentrate (PCC; containing factors 2,7,9,and 10) rapidly reverses VKA-associated bleeding. Despite a rapid reversal of the INR, there is little literature demonstrating a mortality benefit.
  • The EPAHK study was observational-cohort that examined the 7-day mortality of guideline-concordant administration of PCC and vitamin K (GC-PCC-K) for multiple-types of patients with warfarin-associated bleeding.
  • The study demonstrated patients who received GC-PCC-K within 8 hours of presentation had a two-fold decrease in 7-day morality; there was a three-fold reduction when only ICH was considered.