Femoral neck system reduces surgical time and complications in adults with femoral neck fractures: A systematic review and meta-analysis

Published Date: 08th August 2023

Publication Authors: Bonney S, Rimmer C, Graham K

Background
Prothrombin complex concentrate (PCC) is the recommended treatment for major bleeding in patients taking oral anticoagulants such as warfarin, apixaban, edoxaban and dabigatran. Its effectiveness is dependent on timely administration. Delays to treatment beyond one hour are common and adversely affect outcome. PCC is stored at room temperature, sometimes at point of care and sometimes remote from POC in the pathology department or hospital pharmacy. Current recommendations are that PCC should be stored at point of care (POC) with the aim of reducing delays caused by remote storage.

Aims
The objectives of the present study were to investigate whether POC storage of PCC reduced delays to treatment in eligible patient.

Methods:Study Type
A retrospective analysis of prospectively gathered information.

Patients
Adult patients treated with PCC in the Emergency Department (ED) of a general hospital in the UK from March 2021 to February 2023.

Intervention
Reconfigured the clinical pathway in March 2022 from laboratory issue of PCC on a named patient basis to storage at point of care (automated medicines dispensing system) in the ED.

Comparison of outcomes, lab issue PCC (LAB) versus POC PCC:

1. Length of time between decision to give PCC and PCC administration
2. How many patients received PCC withing the recommended 1 hour from decision to treat

Results


Summary/Conclusion
No patients received PCC within an hour of the decision to give in the LAB compared with 29% of in the POC group. The time from decision to administration was also lower in the POC group (3 hours LAB Vs 2.4 hours POC).

Bonney, S; Rimmer, C; Graham, K. (2023). PB2651: A comparison of time to treatment with prothrombin complex concentrate: remote or point of care storage of PCC. HemaSphere. 7(S3), p.e735818c. [Online]. Available at: https://doi.org/10.1097/01.HS9.0000977288.73581.8c [Accessed 1 May 2026]