Reversal Of Warfarin-Associated Coagulopathy Prothrombin Complex Concentrates

Yale University

EliScholar – A Digital Platform for Scholarly Publishing at Yale

Yale Medicine Thesis Digital Library School of Medicine

January 2020

Reversal Of W ersal Of Warfarin-Associated Coagulopathy: Pr farin-Associated Coagulopathy: Prothrombin

Complex Concentr Complex Concentrates Versus F ersus Fresh Frozen Plasma In Elderly en Plasma In Elderly

Patients Presenting With Intracranial Hemorrhage

Shunella Grace Lumas

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Recommended Citation

Lumas, Shunella Grace, "Reversal Of Warfarin-Associated Coagulopathy: Prothrombin Complex

Concentrates Versus Fresh Frozen Plasma In Elderly Patients Presenting With Intracranial Hemorrhage"

(2020). Yale Medicine Thesis Digital Library. 3928.

https://elischolar.library.yale.edu/ymtdl/3928

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Reversal of Warfarin-Associated Coagulopathy: Prothrombin Complex

Concentrates versus Fresh Frozen Plasma in Elderly Patients Presenting with

Intracranial Hemorrhage

A Thesis Submitted to the

Yale University School of Medicine

in Partial Fulfillment of the Requirements for the

Degree of Doctor of Medicine

By Shunella Grace Lumas

2020

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Table of Contents

Title Page 1

Table of Contents 2

Acknowledgements 3

Abstract 4

Introduction 6

The Case for Anticoagulation Therapy 6

Benefits and Dangers of Warfarin 8

Efficacy of Warfarin Reversal Agents 15

PCC vs. FFP: A Superior Agent? 21

Statement of Purpose 28

Methods 29

Results 32

Discussion 37

References 43

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Acknowledgements

I would like to thank my thesis advisor Dr. Kevin Schuster for his guidance

in helping me pursue this project over the years. I would also like to thank the Yale

Department of General Surgery, Trauma, and Surgical Critical Care for allowing me

to pursue my interests in trauma clinical research.

I would like to acknowledge the Yale Office of Student Research for helping

me engage my interests in clinical research, and for giving me the support in

helping my research projects flourish both on-campus and beyond, at the many

conferences and meetings where I was given the unique opportunity to present my

research to my colleagues nationwide. I am also appreciative of the incredibly

supportive research environment cultivated at the Yale School of Medicine

Lastly, I would like to thank all my family and friends, whose unconditional

support allowed me to thrive throughout medical school and no doubt will

continue to uplift me in my upcoming medical training and beyond.