{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:34:54Z","timestamp":1753878894053,"version":"3.41.2"},"reference-count":17,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T00:00:00Z","timestamp":1745366400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>An increasing number of patients in Australia are taking direct oral anticoagulants for a variety of indications since their introduction in the treatment landscape. There has always been some concern about the optimal management approach in the setting of major and\/or life\u2010threatening bleeding. In particular, patients who present with factor Xa inhibitor\u2010associated intracranial haemorrhages are associated with high morbidity and mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To determine the efficacy of pro\u2010haemostatic agents in the management of factor Xa inhibitor\u2010related intracranial haemorrhages.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective audit of rivaroxaban and apixaban\u2010associated intracranial haemorrhages was performed between January 2015 and December 2021, inclusive.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The bleeding\u2010related mortality was similar between the patients who received pro\u2010haemostatic agents versus patients who did not receive pro\u2010haemostatic agents (90% vs 93% respectively). The mean volume expansion for those who received pro\u2010haemostatic agents was +1.0mL versus \u22126.8 mL for patients who did not receive pro\u2010haemostatic agents (<jats:italic>P<\/jats:italic> =\u20090.51, 95% confidence interval: \u221211.7 to +5.9).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients who presented with intracranial haemorrhages in the presence of clinically significant direct oral anticoagulant levels had a higher risk of mortality that does not appear to change with the use of prohaemostatic agents. The efficacy of prohaemostatic agents may not be as clinically significant based on real\u2010world experience in contrast to previously reported studies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.70074","type":"journal-article","created":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T05:31:47Z","timestamp":1745386307000},"page":"1114-1119","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of pro\u2010haemostatic agents in the management of factor Xa inhibitor\u2010associated intracranial haemorrhages"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5620-1659","authenticated-orcid":false,"given":"Sara Shu\u2010Ling","family":"Ng","sequence":"first","affiliation":[{"name":"Haematology Department South Western Sydney Local Health District, Liverpool Hospital  Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health, South West Sydney Clinical School University of New South Wales  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hashim","family":"Noori","sequence":"additional","affiliation":[{"name":"Radiology Department South Western Sydney Local Health District, Liverpool Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diem","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Haematology Department South Western Sydney Local Health District, Liverpool Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhengbang","family":"Wang","sequence":"additional","affiliation":[{"name":"Haematology Department South Western Sydney Local Health District, Liverpool Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danny","family":"Hsu","sequence":"additional","affiliation":[{"name":"Haematology Department South Western Sydney Local Health District, Liverpool Hospital  Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health, South West Sydney Clinical School University of New South Wales  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,4,23]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.004506"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.112.650614"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-021-10448-2"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.111.624650"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.112.675231"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.021831"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/tomography7020011"},{"key":"e_1_2_7_9_1","unstructured":"GalicK WasseliusJ.Time savings using the sectra volume measurement tool \u2013 summary of a study performed at the Neuroradiology Department at Lund University Hospital Sweden;2017[cited Oct 2024]. 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