Title: Reversing Warfarin-Associated Bleeding: The EPAHK Study<br/>Author: Haney Mallemat<br/><a href='http://umem.org/profiles/faculty/785/'>[Click to email author]</a><hr/><div class="page" title="Page 1">
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A feared complication of patients taking vitamin K antagonists (VKA) is life-threatening bleeding (LTB), including intracranial hemorrhage (ICH).</li>
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Prothrombin complex concentrate (PCC; containing factors 2,7,9,and 10) rapidly reverses VKA-associated bleeding. Despite a rapid reversal of the INR, there is little literature demonstrating a mortality benefit.</li>
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The <a href="http://www.ncbi.nlm.nih.gov/pubmed/24762166">EPAHK</a> study was observational-cohort that examined the 7-day mortality of guideline-concordant administration of PCC and vitamin K (GC-PCC-K) for multiple-types of patients with warfarin-associated bleeding.</li>
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The study demonstrated patients who received GC-PCC-K within 8 hours of presentation had a two-fold decrease in 7-day morality; there was a three-fold reduction when only ICH was considered.</li>
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<a href="http://www.ncbi.nlm.nih.gov/pubmed/24762166">Tazarourte, K. et al. <strong>Guideline-concordant administration of prothrombin complex concentrate and vitamin K is associated with decreased mortality in patients with severe bleeding under vitamin K antagonist treatment (EPAHK study).</strong> Crit Care. 2014 Apr 24;18(2):R81.</a></p>
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