Impact of a Pharmacist-Driven Prothrombin Complex Concentrate Protocol on Time to Administration in Patients With Warfarin-Associated Intracranial Hemorrhage

Jessica L. Corio, PharmD; Jonathan H. Sin, PharmD; Bryan D. Hayes, PharmD; Joshua N. Goldstein, MD, PhD; Lanting Fuh, PharmD


Western J Emerg Med. 2018;19(5):849-854. 

In This Article


A total of 79 patients were issued 4F-PCC during the two six-month observational periods under each protocol. Overall, we included 48 patients in the study, with 24 patients in the pre-protocol group and 24 in the pharmacist-driven protocol group (Table 1). The median time to administration of 4F-PCC in the pre-protocol group was 70 minutes (interquartile range (IQR) = 34–89; range, 14–244) compared with 35 minutes (IQR = 25–62; range, 11–133) in the pharmacist-driven protocol group (p=0.034). There were no significant differences in dosing, based on pre-treatment INR and patient weight, between the pre-protocol group and the pharmacist-driven protocol group (p=0.174). All patients, with the exception of two in the pre-protocol group, received concomitant IV vitamin K, either at a referring hospital or in our ED upon diagnosis of warfarin-associated ICH (Table 2). In-hospital mortality occurred at comparable rates between the two study populations (p=1).