Effectiveness of Prothrombin Complex Concentrate for Warfarin-related Intracranial Hemorrhage

Abstract

Warfarin-associated intracranial hemorrhage(w-ICH)usually increases and results in unfavorable outcomes. Administration of prothrombin complex concentrate(PCC)can reverse anticoagulation and correct prothrombin time-international normalized ratio(PT-INR)immediately; it is recommended by some guidelines for cases of w-ICH. We assessed the effect of PCC on blood coagulation. We administered PCC and vitamin K to 11 patients with w-ICH who were admitted to our hospital between October 2016 and November 2017. We measured the PT-INR at baseline and immediately, 1 hour, 6 hours, and on the day after PCC administration. Patients' mean(range)PT-INR normalized from 1.92(1.64-3.26)to 1.08(1.03-1.29)immediately after receiving PCC. Patients' PT-INR was 1.17(1.08-1.29)1 hour after receiving PCC, 1.22(1.16-1.52)6 hours after receiving PCC, and 1.17(1.05-1.29)on the day after receiving PCC. In all the cases, no side effects emerged. Five patients had a safe operation. All the patients' modified Rankin Scale scores at discharge were stable or within a permissive limit in comparison with the symptoms on admission. In our cases, administration of PCC corrected the PT-INR immediately and contributed to a better outcome of w-ICH.