Dados do Trabalho

Título

Prothrombin Complex Concentrates in Trauma-Induced Coagulopathy management: unraveling their impact on hospital and intensive care unit length of stays

Objetivo

Objective: To analyze the effect of prothrombin complex concentrates (PCCs) on hospital and intensive care unit (ICU) length of stay (LOS) in trauma-induced coagulopathy management.

Métodos

Methods: We searched PubMed, Embase, and Web of Science databases from inception to May 18, 2024. We included studies on trauma patients aged 18 years or older not on anticoagulation, with the intervention group treated with either 3-factor (3F-PCC) or 4-factor PCC (4F-PCC) and the control group treated with fresh frozen plasma. Using the inverse variance method, we calculated the mean differences (MD) of ICU and hospital LOS between the intervention and the control groups, with the corresponding 95% confidence intervals (CI). Furthermore, we estimated the effect of 3F-PCC and 4F-PCC in subgroup analysis. For studies quality assessment, we used the Risk of Bias in Non-randomized Studies of Interventions tool.

Resultados

Results: We included four retrospective observational studies pooling 921 patients. The employment of PCC did not significantly reduce hospital (MD -1.20, 95%CI -2.47;0.06) and ICU LOS (MD 0.02, 95%CI -0.37;0.41). In the subgroup meta-analysis, we observed that 4F-PCC reduced hospital LOS (MD -2.06, 95%CI -2.38;-1.30), while 3F-PCC had no overall effect (MD 0.18, 95%CI -1.22;1.58). Quality assessment of the articles indicated a moderate to serious risk of bias.

Conclusão

Conclusion: This systematic review and meta-analysis demonstrated that PCC administration did not reduce hospital or ICU LOS. However, it showed that 4F-PCC was more effective than 3F-PCC in decreasing hospital LOS. We should interpret the results cautiously due to the significant risk of bias within the studies.