ArticleInternal medicine journal2025
Efficacy of pro-haemostatic agents in the management of factor Xa inhibitor-associated intracranial haemorrhages.
Article in Internal medicine journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
backgroundAn increasing number of patients in Australia are taking direct oral anticoagulants for a variety of indications since their introduction in the treatment landscape. There has always been some concern about the optimal management approach in the setting of major and/or life-threatening bleeding. In particular, patients who present with factor Xa inhibitor-associated intracranial haemorrhages are associated with high morbidity and mortality.
aimTo determine the efficacy of pro-haemostatic agents in the management of factor Xa inhibitor-related intracranial haemorrhages.
methodsA retrospective audit of rivaroxaban and apixaban-associated intracranial haemorrhages was performed between January 2015 and December 2021, inclusive.
resultsThe bleeding-related mortality was similar between the patients who received pro-haemostatic agents versus patients who did not receive pro-haemostatic agents (90% vs 93% respectively). The mean volume expansion for those who received pro-haemostatic agents was +1.0mL versus -6.8 mL for patients who did not receive pro-haemostatic agents (P = 0.51, 95% confidence interval: -11.7 to +5.9).
conclusionPatients who presented with intracranial haemorrhages in the presence of clinically significant direct oral anticoagulant levels had a higher risk of mortality that does not appear to change with the use of prohaemostatic agents. The efficacy of prohaemostatic agents may not be as clinically significant based on real-world experience in contrast to previously reported studies.
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