Effect of Fresh Frozen Plasma Transfusion on Prothrombin Time in Patients With Mild Coagulation Abnormalities When Compared With Major Coagulation Abnormalities

Abstract

BACKGROUND Fresh Frozen Plasma (FFP) is frequently transfused to patients with mild to moderate elevations in Prothrombin time (PT) and International Normalized Ratio (INR) under the twin assumptions that these tests imply a coagulopathy and that FFP transfusion will correct the coagulopathy. This study gives an insight into the pattern and appropriateness of fresh frozen plasma transfusion practice among various clinical departments. MATERIALS AND METHODS This is a prospective cohort study done for a period of 2 years from 2013 January on all FFP transfusions for mild and major coagulation abnormalities. Mild means PT 13.1 to 17 seconds and INR 1.1 to 1.85, major means, PT more than 17 seconds and INR more than 1.85. In all patients of both the groups' pre-transfusion PT INR values and post transfusion PT INR values 6 to 8 hours after FFP transfusion were assessed. RESULTS In this study among the 60 major abnormality cases, 86.7 % showed significant improvement in PT INR following FFP transfusion (p< 0.001), whereas in 60 mild cases, only 5% had significant improvement (p= 0.55). CONCLUSION The study revealed that, there was significant improvement in PT INR values after FFP transfusion in major coagulation abnormalities. In mild elevation of PT INR, FFP transfusion did not show any improvement. The study also showed that there is a widespread uncertainty about the appropriate use of FFP among our clinicians despite the existence of various guidelines, resulting in high rate of inappropriate transfusions.