A promising new alternative for the rapid reversal of warfarin coagulopathy in traumatic intracranial hemorrhage.
BACKGROUND
Internationally, Factor IX complex (FIX complex) has been used to correct warfarin-induced coagulopathy. We present our experience with 28 patients using FIX complex.


METHODS
A retrospective chart review was conducted between November 2002 and July 2006 on patients with warfarin-induced coagulopathy. We recorded the dose and timing of FIX complex, serial international normalized ratios (INRs), early adverse events, and patient outcome.


RESULTS
Twenty-eight patients met criteria. The mean INR on admission was 5.1, and after FIX complex infusion was reduced significantly to 1.9 (P = .008). Eleven patients had a repeat INR drawn within 30 minutes after FIX complex infusion. The mean time to correction was 13.5 minutes. There were no early thrombotic events or allergic reactions.


CONCLUSIONS
FIX complex results in an immediate reversal of coagulopathy within 15 minutes after administration. Its use should be considered as an alternative treatment to fresh-frozen plasma and recombinant Factor VIIa. Prospective randomized trials are needed to confirm these findings.
Safaoui
Marian N
MN
Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
Aazami
Roshanak
R
Hotz
Heidi
H
Wilson
Matthew T
MT
Margulies
Daniel R
DR
D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects*; D001778:Blood Coagulation Disorders / Q000139:chemically induced* / Q000188:drug therapy*; D020202:Cerebral Hemorrhage, Traumatic / Q000188:drug therapy*; D005164:Factor IX / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D014859:Warfarin / Q000009:adverse effects*
D000925:Anticoagulants; D014859:Warfarin; D005164:Factor IX