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 |