Evidence map›Paper›PMID 33243152›Full record

ArticleBMC emergency medicine2020

Propensity score adjusted comparison of three-factor versus four-factor prothrombin complex concentrate for emergent warfarin reversal: a retrospective cohort study.

David J Margraf, Scott Seaburg, Gregory J Beilman, Julian Wolfson, Jonathan C Gipson, Scott A Chapman

Open access · goldAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC emergency medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 3 pooled it
0.9field-weighted citation impact, top 22% 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

5 citing papers in PubMed, 3 syntheses or guidelines pooled it, 6 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Pooled it
  4. Review
  5. Observational
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

6 authors at 2 institutions in 1 country.

David J MargrafDepartment of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, 7-115E Weaver-Densford Hall, 308 Harvard St. SE, Minneapolis, MN, 55455, USA.
Scott SeaburgDepartment of Pharmacy Services, North Memorial Health Hospital, Robbinsdale, MN, USA.
Gregory J BeilmanDivision of Critical Care & Acute Care Surgery, Department of Surgery, University of Minnesota, Minneapolis, MN, USA.
Julian WolfsonDivision of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
Jonathan C GipsonTrauma and Acute Care Surgery, North Memorial Health Hospital, Robbinsdale, MN, USA.
Scott A ChapmanDepartment of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, 7-115E Weaver-Densford Hall, 308 Harvard St. SE, Minneapolis, MN, 55455, USA. chapm004@umn.edu.
University of Minnesota · USNorth Memorial Health Care · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundProthrombin Complex Concentrates (PCC) are prescribed for emergent warfarin reversal (EWR). The comparative effectiveness and safety among PCC products are not fully understood.

methodsPatients in an academic level one trauma center who received PCC3 or PCC4 for EWR were identified. Patient characteristics, PCC dose and time of dose, pre- and post-INR and time of measurement, fresh frozen plasma and vitamin K doses, and patient outcomes were collected. Patients whose pre-PCC International Normalized Ratio (INR) was > 6 h before PCC dose or the pre-post PCC INR was > 12 h were excluded. The primary outcome was achieving an INR ≤ 1.5 post PCC. Secondary outcomes were the change in INR over time, post PCC INR, thromboembolic events (TE), and death during hospital stay. Logistic regression modelled the primary outcome with and without a propensity score adjustment accounting for age, sex, actual body weight, dose, initial INR value, and time between INR measurements. Data are reported as median (IQR) or n (%) with p < 0.05 considered significant.

resultsEighty patients were included (PCC3 = 57, PCC4 = 23). More PCC4 patients achieved goal INR (87.0% vs. 31.6%, odds ratio (OR) = 14.4, 95% CI: 3.80-54.93, p < 0.001). This result remained true after adjusting for possible confounders (AOR = 10.7, 95% CI: 2.17-51.24, p < 0.001). The post-PCC INR was lower in the PCC4 group (1.3 (1.3-1.5) vs. 1.7 (1.5-2.0)). The INR change was greater for PCC4 (2.3 (1.3-3.3) vs. 1.1 (0.6-2.0), p = 0.003). Death during hospital stay (p = 0.52) and TE (p = 1.00) were not significantly different.

conclusionsPCC4 was associated with a higher achievement of goal INR than PCC3. This relationship was observed in the unadjusted and propensity score adjusted results.

Indexed as

AgedAged, 80 and overAnticoagulantsBlood Coagulation FactorsBody WeightEmergenciesFemaleHumansInternational Normalized RatioMaleMiddle AgedPlasmaPropensity ScoreRetrospective StudiesTime FactorsTrauma CentersAnticoagulantsBlood Coagulation Factorsprothrombin complex concentratesVitamin KWarfarinAnticoagulantsBlood coagulation factorsHemorrhageHemostasisWarfarin

Identifiers

PMID33243152
PMCPMC7691107
OpenAlexW3106630695

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.