alexa Validation of a Scoring System for Prediction of Clinical Outcome in the Offlabel Use of Recombinant Factor VIIa
ISSN: 2329-8790

Journal of Hematology & Thromboembolic Diseases
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Research Article

Validation of a Scoring System for Prediction of Clinical Outcome in the Offlabel Use of Recombinant Factor VIIa

Galila Zaher*, Soheir Adam, Fatima Azher, Salwa Hindawi and Ghazi Damanhouri
King Abdulaziz University Hospital, Jeddah, Saudi Arabia
Corresponding Author : Galila Zaher
King Abdulaziz University Hospital, Jeddah, Saudi Arabia
Tel: 00966543025300
E-mail: [email protected]
Received: June 03, 2015 Accepted: July 10, 2015 Published: July 17, 2015
Citation: Zaher G, Adam S, Azher F, Hindawi S, Damanhouri G (2015) Validation of a Scoring System for Prediction of Clinical Outcome in the Off-label Use of Recombinant Factor VIIa. J Hematol Thrombo Dis S1:003. doi:10.4172/2329-8790.1000S1003
Copyright: © 2015 Zaher G, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Abstract

Background and Objectives: Recombinant factor VIIa (rFVIIa) is approved for treatment of inhibitors in hemophilia but has also been used for numerous off-label indications. Type of study: This study aims to validate a modified Biss scoring system in patients who received recombinant factor rFVIIa in Jeddah, Saudi Arabia. Materials and Methods: We included 70 patients who received rFVIIa for off-label indications over 12 months. Characteristics of survivor and non-survivor groups were compared including demographics, laboratory and clinical data. Using a modified Biss prognostic scoring system, based on the original scoring system used by Biss and Hanley, patients were divided into low (<1), intermediate (1-2) and high (≥3) score groups. Results: The mean age of patients was 46.1(±18.6) years. The most common off-label indications for rFVIIa treatment were to control bleeding associated with cardiac surgery (33%) and management of intracranial hemorrhage (18.8%). Forty three patients (61.6%) were at low risk, 20(28.6%) were at intermediate risk, and 7 (10%) were at high risk. Survivors were younger than non-survivors and less likely to have coagulopathy, or renal impairment at the time of treatment. The total prognostic score correlated to survival outcome (P ≤ 0.042); 73.2%, 22%, 4.9% of survivors had a low, intermediate and high score, respectively. Conclusions: Our results suggest that a modified Biss score could help predict survival of patients receiving rFVIIa. Prospective studies are needed to further validate the utility of this scoring system.

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