Abstract：
OBJECTIVE: The purpose of this review is to evaluate current literature on the treatment of factor Xa inhibitor-associated bleeds with 4-factor prothrombin complex concentrate (4F-PCC), with a focus on the effect of low versus high dosing of 4F-PCC on hemostatic efficacy and safety outcomes.
CONCLUSIONS: A search of PubMed and EBSCOhost was performed to identify studies evaluating patients with a factor Xa inhibitor-bleed treated with 4F-PCC at either low or high doses. Studies of patients receiving alternative reversal agents such as fresh frozen plasma and andexanet alfa or where no comparator group was evaluated were excluded from the analysis. To assess the effect of these 4F-PCC dosing strategies, the primary outcome of interest was hemostatic efficacy. Four studies meeting inclusion criteria were included in this review. In each of the included studies, similar rates of hemostatic efficacy, hospital mortality, and venous thromboembolism were observed in the low- and high-dose cohorts.
CONCLUSIONS: These results suggest low- and high-dose 4F-PCC may confer similar clinical effectiveness and safety; however, these findings should be evaluated and confirmed with future prospective studies.
CONCLUSIONS: A search of PubMed and EBSCOhost was performed to identify studies evaluating patients with a factor Xa inhibitor-bleed treated with 4F-PCC at either low or high doses. Studies of patients receiving alternative reversal agents such as fresh frozen plasma and andexanet alfa or where no comparator group was evaluated were excluded from the analysis. To assess the effect of these 4F-PCC dosing strategies, the primary outcome of interest was hemostatic efficacy. Four studies meeting inclusion criteria were included in this review. In each of the included studies, similar rates of hemostatic efficacy, hospital mortality, and venous thromboembolism were observed in the low- and high-dose cohorts.
CONCLUSIONS: These results suggest low- and high-dose 4F-PCC may confer similar clinical effectiveness and safety; however, these findings should be evaluated and confirmed with future prospective studies.
摘要：
结论：为了加快文章的发表，AJHP在接受后尽快在线发布手稿。接受的手稿经过同行评审和复制编辑，但在技术格式化和作者打样之前在线发布。这些手稿不是记录的最终版本，将在以后替换为最终文章（按照AJHP样式格式化并由作者证明）。
目的：这篇综述的目的是评估目前关于用4因子凝血酶原复合物浓缩物（4F-PCC）治疗Xa因子抑制剂相关出血的文献，重点关注4F-PCC低剂量与高剂量对止血效果和安全性结局的影响。
结论：对PubMed和EBSCOhost进行了搜索，以确定评估接受低剂量或高剂量4F-PCC治疗的Xa因子抑制剂出血患者的研究。对接受替代逆转剂如新鲜冷冻血浆和andexanetalfa或未评估比较组的患者的研究被排除在分析之外。为了评估这些4F-PCC给药策略的效果，感兴趣的主要结局是止血效果.4项符合纳入标准的研究纳入本综述。在每一项纳入的研究中，止血功效的相似率，医院死亡率，在低剂量和高剂量队列中观察到静脉血栓栓塞.
结论：这些结果表明，低剂量和高剂量4F-PPC可能具有相似的临床有效性和安全性；然而，这些发现应通过未来的前瞻性研究进行评估和确认.
目的：这篇综述的目的是评估目前关于用4因子凝血酶原复合物浓缩物（4F-PCC）治疗Xa因子抑制剂相关出血的文献，重点关注4F-PCC低剂量与高剂量对止血效果和安全性结局的影响。
结论：对PubMed和EBSCOhost进行了搜索，以确定评估接受低剂量或高剂量4F-PCC治疗的Xa因子抑制剂出血患者的研究。对接受替代逆转剂如新鲜冷冻血浆和andexanetalfa或未评估比较组的患者的研究被排除在分析之外。为了评估这些4F-PCC给药策略的效果，感兴趣的主要结局是止血效果.4项符合纳入标准的研究纳入本综述。在每一项纳入的研究中，止血功效的相似率，医院死亡率，在低剂量和高剂量队列中观察到静脉血栓栓塞.
结论：这些结果表明，低剂量和高剂量4F-PPC可能具有相似的临床有效性和安全性；然而，这些发现应通过未来的前瞻性研究进行评估和确认.
