Cardiothoracic & vascular anesthesia
Trends in the Use of Recombinant Activated Factor VII and Prothrombin Complex Concentrate in Heart Transplant Patients in Virginia
Authors' conclusion
Use of rFVIIa in HTx decreased over the past decade, whereas off-label PCC use increased. Receipt of rFVIIa was associated with thrombosis; however, patients who received rFVIIa were more severely ill, and risk adjustment may have been incomplete.
Study context
- Population
- Adults undergoing heart transplantation (HTx) in Virginia hospitals, 2012–2022
- Participants
- 899 adults
- Exposure
- Off-label rFVIIa, on-label prothrombin complex concentrate (PCC) and off-label PCC use: trends over time and association with postoperative thrombosis
- rFVIIan = 100
- On-label PCCn = 69
- Off-label PCCn = 80
- Outcome
- Use of procoagulant factor concentrates and trend over the 10-year period
Methodological detailsstatewide database, multivariate logistic regression
- Statewide database
- Multivariate logistic regression
Main finding
As reported in the abstract
- Downward trend in rFVIIa use
- P = 0.04
- No trend in on-label PCC use
- P = 0.12
- Increase in off-label PCC use
- P < 0.001
Observational data: associations, not effects.
Further findings
Transfusion and CPB time in rFVIIa recipients
- Patients who received rFVIIa were transfused more and had longer CPB time
- P < 0.001
Safety
Postoperative thrombosis
| OR (95% CI) | P value | ||
|---|---|---|---|
| rFVIIaMultivariate logistic regression | 1.92 (1.12–3.29) | P = 0.02 | |
| On-label PCCMultivariate logistic regression | 0.98 (0.49–1.96) | P = 0.96 | |
| Off-label PCCMultivariate logistic regression | 0.61 (0.29–1.30) | P = 0.20 | |
| 0.20.5125Odds ratio (log scale) |
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Trends in the Use of Recombinant Activated Factor VII and Prothrombin Complex Concentrate in Heart Transplant Patients in Virginia. J Cardiothorac Vasc Anesth. Published 4 October 2023. doi:10.
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