目的:我们试图描述目前在创伤患者中使用凝血酶原复合物浓缩物(PCC)和纤维蛋白原浓缩物(FC)的实践模式。
背景:创伤诱导的凝血病(TIC)和创伤内皮病(EOT)对创伤出血的死亡率有显著影响。FC,4因素PCC是EOT和TIC的潜在治疗方法,分别。
方法:我们从创伤质量改善计划(TQIP)注册中心获得了数据,并使用程序代码识别了接受PCC或FC的患者。我们使用描述性统计数据来描述这些产品的实践模式。
结果:从2017年到2022年,TQIP中总共有6714002次相遇,其中10589次获得PCC,3009次获得FC。在收件人中,这两种产品都收到了35个。有44人同时收到。PCC接受者的中位年龄为77(69-84),其中19名患者年龄<15岁,最年轻的为2岁。记录使用PCC的设施数量总体呈上升趋势:分别为155/744、168/766、189/764、206/780、234/795和235/816。FC接受者的中位年龄为57(32-75),其中48例患者年龄<15岁,最年轻的为1岁。记录使用FC的设施数量略有下降:55、44、39、32、38和40。
结论:PCC和FC的管理仍然不常见,尽管PCC的使用似乎呈上升趋势。大多数PCC的使用似乎是在头部创伤的情况下用于抗凝逆转。指导使用这些产品的数据是必要的,因为这些产品越来越被认为是创伤性出血控制的辅助手段。
OBJECTIVE: We seek to describe the current practice pattern use of
prothrombin complex concentrate (PCC) and fibrinogen concentrate (FC) in trauma patients.
BACKGROUND: Trauma-induced coagulopathy (TIC) and endotheliopathy of trauma (EOT) contribute significantly to mortality from traumatic haemorrhage. FC, and 4-factor PCC are potential treatments for EOT and TIC, respectively.
METHODS: We obtained data from the Trauma Quality Improvement Program (TQIP) registry and identified patients who received either PCC or FC using procedural codes. We used descriptive statistics to characterise practice patterns of these products.
RESULTS: There were 6 714 002 total encounters within the TQIP from 2017 to 2022, of which 10 589 received PCC and 3009 received FC. Of the recipients, there were 35 that received both products. There were 44 that received both. The median age of PCC recipients was 77 (69-84) with 19 patients <15 years of age with the youngest being 2 years of age. There was a general upward trend in the number of facilities with documented use of PCC: 155/744, 168/766, 189/764, 206/780, 234/795, and 235/816, respectively. The median age of FC recipients was 57 (32-75) with 48 patients <15 years of age with the youngest being 1 year of age. There was a minor downward trend in the number of facilities that had documented use of FC: 55, 44, 39, 32, 38 and 40.
CONCLUSIONS: The administration of PCC and FC remains uncommon, although there appears to be an upward trend of PCC use. Most PCC use appeared to be for anticoagulation reversal in the setting of head trauma. Data guiding the use of these products are necessary as these products become more recognised as adjuncts to traumatic haemorrhage control.