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Table 5 Studies investigating the available anticoagulation reversal agents' impact on patient survival

From: Treatments for reversing warfarin anticoagulation in patients with acute intracranial hemorrhage: a structured literature review

Author Study type Patient population Intervention Result Grade [14]
Berwaerts et al. 2000 Retrospective 68 patients with WAICH 19 patients received vitamin K only, 11 vitamin K + FFP, 5 FFP, 3 vitamin K + FFP + factor IX, 2 vitamin K + factor IX, 2 factor IX, and 26 were treated with an "expectant attitude" No significant difference in mortality rate among patients who had been reversed with any combination of reversal agents or had not been reversed Low
Sjoblom et al. 2001 Retrospective 136 patients with WAICH who received some form of reversal Either single therapy or combinations of vitamin K, factor IX, FFP, or no therapy was administered No evidence that any treatment strategy was superior to the others Moderate
Huttner et al. 2006 Retrospective 55 patients with WAICH Compared vitamin K, PCC, and FFP alone or in some combination Incidence and extent of hematoma growth were significantly lower in the PCC-treated group. If the INR was normalized within 2 h then FFP and PCC influence on hematoma growth were similar Low
Goldstein et al. 2006 Retrospective 69 patients with non traumatic WAICH with INR > 1.4 Patients received no therapy, FFP, vitamin K, or combination Patients whose INR was successfully reversed within 24 h had a shorter time from diagnosis to first dose of FFP (90 vs. 210 min). Shorter time to vitamin K as well predicted INR correction. Every 30 min of delay in the first dose of FFP was associated with 20% decreased odds of INR reversal within 24 h. No ED intervention was associated with improved clinical outcome Moderate
Yasaka et al. 2003 Prospective 15 patients with WAICH 9 PCCs with vitamin K 10-20 mg IV, 2 PCCs alone or 4 with vitamin K 10-20 mg IV alone were administered based on decision of treating MD Vitamin K lowered the INR after 12-24 h to normalized range. PCC with or without vitamin K was more effective at rapidly correcting the increased INR. PCC without vitamin K administration led to a recurrent increase in INR after 12-24 h Low