title: The effect of fresh frozen plasma transfusion on international normalized ratio in emergency department patients.
abstract: BACKGROUND
  There are few studies researching the effect of fresh frozen plasma (FFP) transfusion on international normalized ratio (INR) in patients with coagulation abnormality.
  
  
  OBJECTIVE
  This 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.
  
  
  METHODS
  Adult 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.
  
  
  RESULTS
  Eighty-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).
  
  
  CONCLUSIONS
  A 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.
authors: Department of Emergency Medicine, Tepecik Training and Research Hospital, Izmir, Turkey.
authors: Savaş
authors: S
authors: Sezik
authors: Department of Emergency Medicine, Tepecik Training and Research Hospital, Izmir, Turkey.
authors: Ersin
authors: E
authors: Aksay
authors: Department of Emergency Medicine, Tepecik Training and Research Hospital, Izmir, Turkey.
authors: Turgay Yılmaz
authors: TY
authors: Kılıç
mesh_terms: D000368:Aged; D001778:Blood Coagulation Disorders / Q000628:therapy*; D016913:Blood Component Transfusion; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D010949:Plasma; D012189:Retrospective Studies
keywords: INR; blood transfusion; emergency department; fresh frozen plasma; international normalized ratio; transfusion