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Efficacy of Prothrombin Complex Concentrate versus Fresh Frozen Plasma in Patients with Bleeding in the Emergency Department

Introduction In the emergency department, abnormal bleeding can be seen in patients due to defective hemostasis mechanisms. In addition to drug use, conditions such as liver disease and kidney failure can increase the potential for abnormal bleeding (1). In recent years, there has been an increase in the number of patients admitted to the emergency department with warfarin-related complications. Warfarin is important for emergency physicians because it is associated with bleeding complications when the therapeutic range is exceeded and its interactions with drugs are frequent (2). The frequency of emergency department admissions as a result of developing complications is also mentioned. It is also stated that the risk of life-threatening or fatal bleeding is between 1-3% (3,4). The International Normalized Ratio (INR) is used as a follow-up parameter for warfarin treatment effectiveness. These INR values reflect the extent of anticoagulation that minimizes the risk of serious bleeding while reducing morbidity from thromboembolic disease. For most indications, the INR range of 2-3 is used. Patients with high INR values, asymptomatic or with accompanying bleeding findings, are frequently evaluated in the emergency department (5,6). To achieve this, fresh frozen plasma (FFP) and prothrombin complex concentrates (PCC) are used today. Both have their advantages and disadvantages. FFP is plasma obtained by separating whole blood from erythrocytes and platelets and freezing within eight hours after collection. FFP is suitable for rapid replacement in