{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:40:48Z","timestamp":1787240448423,"version":"build-2736575974"},"reference-count":13,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Appl Thromb Hemost"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p>Background: Our institution introduced fixed-dose prothrombin complex concentrate (PCC) to streamline order verification and medication administration. Previous studies using fixed-dose PCC for vitamin K antagonist reversal showed comparable efficacy to weight-based dosing. Objective: To compare fixed versus weight-based PCC dosing for reversal of Factor Xa Inhibitor (FXaI) effects. Methods: Retrospective cohort study conducted at a tertiary care academic medical center. Patients who received PCC to reverse the effects of apixaban or rivaroxaban were eligible. Subjects in the fixed-dose group (5000 units or 2000 units) were compared to weight-based PCC (50 units\/kg). The primary outcome was time between order entry and medication administration. Secondary outcomes included: average PCC dose, postadministration procedures, achieved hemostasis, 30-day mortality, hospital length of stay, and adverse drug events. Results: 72 patients received fixed-dose PCC and 101 received weight-based PCC. Median time between order entry and administration was 4.5\u2005min shorter in the fixed-dose group compared to weight-based (34.5 vs 39\u2005min, P\u2009=\u2009.10). In patients who received fixed-dose, 79.2% achieved hemostasis versus 71.3% in the weight-based group (RR\u2009=\u20091.11, 95% CI\u2009=\u20090.94-1.32). There was no difference in the number of subsequent hemorrhage-related surgeries (29.2% vs 36.7%, RR\u2009=\u20090.80, 95% CI\u2009=\u20090.51-1.24) or mortality rate (26.4% vs 35.6%, RR\u2009=\u20090.73, 95% CI\u2009=\u20090.46-1.17). There were zero adverse drug events reported. Rates of thrombosis were 2.8% and\u2009&lt;\u20091% ( P\u2009=\u2009.57) in the fixed and weight-based groups, respectively. Conclusion and Relevance: The fixed-dosing strategy did not reduce time to PCC administration nor impact hemostasis or mortality. These data support that the fixed-dosing method is a viable option.<\/jats:p>","DOI":"10.1177\/10760296241243368","type":"journal-article","created":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T18:08:56Z","timestamp":1715018936000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Comparison of Fixed Versus Weight-Based Prothrombin Complex Concentrate Dosing Strategies for Factor Xa Inhibitor Reversal"],"prefix":"10.1177","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8889-1433","authenticated-orcid":false,"given":"Snyder","family":"Brett","sequence":"first","affiliation":[{"name":"Department of Pharmacy, UPMC Mercy, Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6762-123X","authenticated-orcid":false,"given":"Miller","family":"Taylor","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, UPMC Mercy, Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"McCormick","family":"Pamela","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, UPMC Mercy, Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gionfriddo","family":"Michael","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Duquesne University, Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,5,6]]},"reference":[{"issue":"12","key":"bibr1-10760296241243368","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2021.37288","volume":"4","author":"Wheelock K","year":"2021","journal-title":"JAMA Network Open"},{"issue":"5","key":"bibr2-10760296241243368","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1016\/j.jacc.2020.04.053","volume":"76","author":"Tomaselli GF","year":"2020","journal-title":"J Am Coll 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2013."},{"issue":"5","key":"bibr11-10760296241243368","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/j.annemergmed.2008.01.329","volume":"52","author":"Berk W","year":"2008","journal-title":"Ann Emerg Med."},{"key":"bibr12-10760296241243368","author":"Kalfsvel L","year":"2023","journal-title":"Eur J Hosp Pharm"},{"issue":"15","key":"bibr13-10760296241243368","doi-asserted-by":"crossref","first-page":"1706","DOI":"10.1182\/blood-2017-05-782060","volume":"130","author":"Majeed A","year":"2017","journal-title":"Blood"}],"container-title":["Clinical and Applied 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