The Effect of Fresh Frozen Plasma Transfusion on International Normalized Ratio in Emergency Department Patients

Abstract

BackgroundThere are few studies researching the effect of fresh frozen plasma (FFP) transfusion on international normalized ratio (INR) in patients with coagulation abnormality. ObjectiveThis study's aim was to determine the effect of FFP transfusion on INR as calculated pretransfusion. In addition, patients were grouped according to pretransfusion INR to determine the improvement in INR per unit of FFP. MethodsAdult patients who had been admitted to our Emergency Department (ED) with coagulation abnormality and received an FFP transfusion, and had pre- and posttransfusion coagulation tests performed, were included in the study. Patients were categorized into five groups according to their pretransfusion INR levels. Improvement in INR per unit of FFP-transfused values (Δ INR 1 unit FFP) was determined for each group. ResultsEighty-seven patients were entered into the study, and were administered a total of 199 units of FFP. Δ INR 1 unit FFP value was 0.03 ± 0.13 for patients whose pretransfusion INR level was under 2; 0.77 ± 0.47 for those between 2 and 5; 2.14 ± 0.63 for those between 5 and 9; 3.34 ± 0.89 for those between 9 and 12; and 4.63 ± 1.99 for those over 12. A very strong positive correlation was found between pretransfusion INR and Δ INR 1 unit FFP (p < 0.001, r = 0.957). ConclusionA significant improvement in INR was observed in patients with higher pretransfusion INR. While determining FFP dose for patients admitted to the ED due to coagulation defect, pretransfusion INR value should be taken into account.