Key result
Idarucizumab use in patients on dabigatran with bleeding or needing urgent surgery was safe and effective but underutilized, being administered to only 14 of 80 eligible patients.
Why the study?
To audit dabigatran-treated patients presenting with bleeding or requiring urgent surgery, assessing whether idarucizumab was appropriately administered and evaluating clinical outcomes.
Does idarucizumab safely and effectively reverse dabigatran in patients presenting with bleeding or requiring urgent surgery?
Observational (n=80)
No
Does idarucizumab safely and effectively reverse dabigatran in patients presenting with bleeding or requiring urgent surgery?
Idarucizumab is safe and effective for dabigatran reversal in real-world clinical practice, but increased awareness is needed to prevent underutilisation.
Idarucizumab was safe and effective when used but underutilized; leaves open optimal real-world implementation strategies.
This retrospective audit reviews patients on dabigatran presenting with bleeding or requiring urgent surgery in the Wellington region, whether they received idarucizumab appropriately and the outcome of episodes. Eighty patients were identified with bleeding or need for urgent surgery, 14 of which received idarucizumab. In patients who received idarucizumab, use was safe, effective and overall appropriate. Idarucizumab was underutilised with patients who could have benefited not receiving it; however, some patients who were treated may not have required it. Increased awareness and use may improve outcomes.
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Wheeler et al. (2019) conducted an observational in Patients on dabigatran presenting with bleeding or requiring urgent surgery (n=80). Idarucizumab vs. No idarucizumab was evaluated on Appropriateness of idarucizumab use and outcome of episodes. Idarucizumab use in patients on dabigatran with bleeding or needing urgent surgery was safe and effective but underutilized, being administered to only 14 of 80 eligible patients.
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