Association of four-factor prothrombin complex concentrate with subsequent plasma transfusion: A retrospective cohort study.

OBJECTIVE: To assess whether patients prescribed four-factor prothrombin complex concentrate (4FPC) received less plasma during the following 24-hour period than those treated for the same indications who received only plasma. INTRODUCTION: It is unclear whether 4FPC is associated with a reduction in subsequent plasma transfusion. This is important for minimising transfusion-associated risks and for inventory management. MATERIALS AND METHODS: We retrospectively studied patients treated for bleeding or coagulopathy. Individuals receiving 4FPC were matched by indication to patients treated with only plasma. Blood products received during 24-hour follow up were compared between 4FPC and plasma-only patients. RESULTS: There was no difference in the number of patients receiving additional plasma (19 (21%) 4FPC patients vs 31 (34%) plasma-only patients, P = .07) nor in the median number of additional plasma units received (0 units for both groups, interquartile range [0, 0] for 4FPC patients vs [0, 1] for plasma-only patients, P = .09). Subgroup analysis comparing patients who received 4FPC for on-label vs off-label indications found no difference in the number of patients receiving plasma nor in the median number of plasma units received. CONCLUSION: 4FPC was prescribed to a diverse set of patients, and administration was not associated with reduced plasma transfusion at our institution.