Further studies are required to assess whether adjusting the PCC

Further studies are required to assess whether adjusting the PCC dose or better management of INR or both would improve survival rates.Key messages? In the VKA effect reversal, a mean dose of 25 IU/kg PCC appears to be efficacious to achieve a target INR of 1.5.? Target INR achievement and bleeding control are strong predictors for survival, regardless of hemorrhage site.? In real-life conditions, management of severe bleeding should be improved with respect to PCC dosing and concomitant vitamin K administration.? INR monitoring was not in line with French guidelines. The delay between PCC infusion and first INR monitoring should be shortened.? Bleeding control and target INR achievement were independent predictors of survival.AbbreviationsDIC: disseminated intravascular coagulation; FFP: fresh frozen plasma; HR: hazard ratio; INR: international normalized ratio; PCC: prothombin concentrated complex; VKA: vitamin K antagonist.Competing interestsDuring the past five years, TD has received fees from Octapharma France (Paris, France) and LFB (Paris, France) for serving on advisory boards and providing lectures. C-MS has received fees from Octapharma, LFB, Baxter (Deerfield, IL, USA), and CSL Behring (King of Prussia, PA, USA) for serving on advisory boards and providing lectures. CG and CH have received fees from Octapharma France. PC works as an independent statistician and has received fees from Octapharma for conducting the study and analyzing data. JCC is an employee of Octapharma. RJ has received fees from Octapharma France, LFB, and CSL Behring. ED, FP, and SJ declare that they have no competing interests.Authors’ contributionsTD participated in the design of the study and in the analysis of the results and wrote the manuscript. PC participated in the design and coordination of the study, performed the statistical analysis, and helped to draft the manuscript. JCC participated in the design and coordination of the study, reviewed the statistical results, and helped to draft the manuscript. All authors have read and approved the final manuscript.