Hemostatic agent (Table ​(Table33)

Use of hemostatic agents

If weight or dosage data are missing, the initial dosing amount for the patient was not calculated

Days of the drug administration during hospitalization were counted and if once the administration was interrupted then re-started, days of the interrupted periods were not included in the calculation, and only days of drug administration were added

FVIII factor VIII, rFVIIa recombinant activated factor VII, aPCC activated prothrombin complex concentrate, FVIIa/FX plasma-derived factor VIIa and factor X, DDAVP desmopressin acetate hydrate

Among the 4 hemostatic agent groups (bypassing agents, FVIII agents, tranexamic acids, and DDAVP), bypassing agents were the most frequently used with 45.3% (153 patients) followed by tranexamic acid with 34.3% (116 patients). FVIII agents and DDAVP were relatively less used (8 and 2 patients, respectively). Focusing on the analysis of bypassing agent use, rFVIIa was the most frequent with 38.2% (129 patients), followed by aPCC with 10.7% (36 patients) and FVIIa/FX with 4.1% (14 patients). The median total initial dose (Q1/Q3) on the first date was 221.98 (121.36/319.15) μg/kg for rFVIIa, 91.59 (68.18/150.00) U/kg for aPCC, and 104.00 (87.80/109.86) μg/kg for FVIIa/FX. The median duration of administration was 5.0 (2.0/10.0) days for of rFVIIa, 6.0 (4.0/8.5) days for of aPCC and 2.5 (1.0/4.0) days for FVIIa/FX (Table ​(Table3).3). The number of doses was 2.0 times (per day) in maximum for all hemostatic agents. Since some patients had the records of multiple hemostatic agents use in the same periods, the overall usage rate exceeded 100%.

Transfusions were conducted with human RBC fluid (53.8%, 182 patients) and fresh frozen human plasma (20.7%, 70 patients).

Plasmapheresis therapy was rare (1.5%, 5 patients).