Evidence map›Paper›PMID 26545367›Full record

ArticleNeurocritical care2016

The Role of FEIBA in Reversing Novel Oral Anticoagulants in Intracerebral Hemorrhage.

Jamil R Dibu, Jonathan M Weimer, Christine Ahrens, Edward Manno, Jennifer A Frontera

Abstract read
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In one paragraph

Article in Neurocritical care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed
7.1field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 63 citations in OpenAlex.

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  13. Article
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  15. Reversal of direct oral anticoagulants.Vascular health and risk management · 2017
    Review
  16. Therapies for Hemorrhagic Transformation in Acute Ischemic Stroke.Current treatment options in neurology · 2017
    Review
  17. Article
  18. Review
  19. Review
  20. Investigation of the Optimal Dose aPCC in Reversing the Effect of Factor Xa Inhibitors-An In Vitro Study.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Jamil R DibuCerebrovascular Center of the Neurological Institute, Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH, 44195, USA.
Jonathan M WeimerCerebrovascular Center of the Neurological Institute, Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH, 44195, USA.
Christine AhrensCerebrovascular Center of the Neurological Institute, Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH, 44195, USA.
Edward MannoCerebrovascular Center of the Neurological Institute, Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH, 44195, USA.
Jennifer A FronteraCerebrovascular Center of the Neurological Institute, Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH, 44195, USA. frontej@ccf.org.
The Neurological Institute · USCleveland Clinic · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundActivated prothrombin complex concentrates factor eight inhibitor bypassing activity (FEIBA) has been recommended for reversing novel oral anticoagulants (NOAC) in the context of intracerebral hemorrhage (ICH), though few clinical studies report its use.

methodsA prospective study of patients with spontaneous ICH was conducted from May 2013 to May 2015. Hospital complications including hemorrhage (gastrointestinal bleeding, anemia requiring transfusion, and surgical site bleeding) and thrombosis (pulmonary embolus, deep vein thrombosis, ischemic stroke, and myocardial infarction) were recorded. All ICH patients underwent baseline head CT and a follow-up stability scan in 6 h. NOAC taken within 48 h of presentation was reversed with FEIBA (50 u/kg) per protocol. Three-month outcomes were assessed using the modified rankin score (mRS).

resultsOf 127 ICH patients enrolled, 6 (5 %) had NOAC-related ICH including: oral factor XA inhibitor N = 5 (4 %; N = 4 rivaroxaban, N = 1 apixaban] and direct thrombin inhibitor N = 1 (0.8 %; dabigatran). The indication for NOAC was atrial fibrillation in all patients and the median CHADS2-VASC score was 4 (range 2-5). The median admission NIHSS was 2 (range 0-14) and the median ICH volume was 8 mL (range 1-20). Five patients (3 rivaroxaban, 1 apixaban, 1 dabigatran) presented within 48 h and received FEIBA within a median of 13 h (range 10-29 h) from their last NOAC dose and 8 h (range 4.5-20) from the time last known well. None of the patients had ICH expansion, hemorrhagic, or thrombotic complications. Three-month median mRS was 1 (range 0-6).

conclusionIn this small case series, reversal of NOAC with FEIBA was not associated with ICH expansion or any thrombotic or hemorrhagic complications.

Indexed as

Outcome Assessment, Health CareAgedAged, 80 and overAntithrombinsBlood Coagulation FactorsCerebral HemorrhageCoagulantsFactor Xa InhibitorsFemaleHumansMaleMiddle AgedRetrospective Studiesanti-inhibitor coagulant complexAntithrombinsBlood Coagulation FactorsCoagulantsFactor Xa InhibitorsActivated prothrombin complex concentrateAnticoagulant-related intracerebral hemorrhage reversalIntracerebral hemorrhageNovel oral anticoagulants

Identifiers

PMID26545367
OpenAlexW2191895465

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.