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

Feb 05, 2024

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

This study aims to evaluate effect of 4-factor PCC on outcomes of severe TBI patients on preinjury anticoagulants undergoing craniotomy/craniectomy.
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.
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).
PCC may be a safe adjunct for urgent reversal of coagulopathy in TBI patients using preinjury anticoagulants.

Copyright © 2024 Elsevier Inc. All rights reserved.

Author

admin

View all posts

ABOUT THE EXPERTS

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

Sai Krishna Bhogadi

Division of Trauma, Critical Care, Burns, and Emergency Surgery, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA. Electronic address: saikbhogadi@arizona.edu.

Adam Nelson

Division of Trauma, Critical Care, Burns, and Emergency Surgery, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA. Electronic address: adamcnelson@arizona.edu.

Hamidreza Hosseinpour

Division of Trauma, Critical Care, Burns, and Emergency Surgery, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA. Electronic address: hosseinpourh@arizona.edu.

Tanya Anand

Division of Trauma, Critical Care, Burns, and Emergency Surgery, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA. Electronic address: tanyaanand@surgery.arizona.edu.

Omar Hejazi

Division of Trauma, Critical Care, Burns, and Emergency Surgery, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA. Electronic address: ohejazi@arizona.edu.

Christina Colosimo

Division of Trauma, Critical Care, Burns, and Emergency Surgery, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA. Electronic address: ccolosim@arizona.edu.

Audrey L Spencer

Division of Trauma, Critical Care, Burns, and Emergency Surgery, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA. Electronic address: audreylspencer@arizona.edu.

Michael Ditillo

Division of Trauma, Critical Care, Burns, and Emergency Surgery, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA. Electronic address: mfditillo@surgery.arizona.edu.

Louis J Magnotti

Division of Trauma, Critical Care, Burns, and Emergency Surgery, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA. Electronic address: lmagnotti@arizona.edu.

Bellal Joseph

Division of Trauma, Critical Care, Burns, and Emergency Surgery, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA. Electronic address: bjoseph@surgery.arizona.edu.