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

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.

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Déclaration de conflit d'intérêts

Declaration of competing interest There are no identifiable conflicts of interest to report. Bellal Joseph reports honoraria for travel and lecture from CSL Behring. All other authors have no financial or proprietary interest in the subject matter or materials discussed in the manuscript.