Details

Autor(en) / Beteiligte

• Wilson, Duncan
• Seiffge, David J
• Traenka, Christopher
• Basir, Ghazala
• Purrucker, Jan C
• Rizos, Timolaos
• Sobowale, Oluwaseun A
• Sallinen, Hanne
• Yeh, Shin-Joe
• Wu, Teddy Y
• Ferrigno, Marc
• Houben, Rik
• Schreuder, Floris H B M
• Perry, Luke A
• Tanaka, Jun
• Boulanger, Marion
• Al-Shahi Salman, Rustam
• Jäger, Hans R
• Ambler, Gareth
• Shakeshaft, Clare
• Yakushiji, Yusuke
• Choi, Philip M C
• Staals, Julie
• Cordonnier, Charlotte
• Jeng, Jiann-Shing
• Veltkamp, Roland
• Dowlatshahi, Dar
• Engelter, Stefan T
• Parry-Jones, Adrian R
• Meretoja, Atte
• Werring, David J

Titel

Outcome of intracerebral hemorrhage associated with different oral anticoagulants

Ist Teil von

• Neurology, 2017-05, Vol.88 (18), p.1693-1700

Ort / Verlag

United States

Erscheinungsjahr

2017

Quelle

MEDLINE

Beschreibungen/Notizen

• In an international collaborative multicenter pooled analysis, we compared mortality, functional outcome, intracerebral hemorrhage (ICH) volume, and hematoma expansion (HE) between non-vitamin K antagonist oral anticoagulation-related ICH (NOAC-ICH) and vitamin K antagonist-associated ICH (VKA-ICH). We compared all-cause mortality within 90 days for NOAC-ICH and VKA-ICH using a Cox proportional hazards model adjusted for age; sex; baseline Glasgow Coma Scale score, ICH location, and log volume; intraventricular hemorrhage volume; and intracranial surgery. We addressed heterogeneity using a shared frailty term. Good functional outcome was defined as discharge modified Rankin Scale score ≤2 and investigated in multivariable logistic regression. ICH volume was measured by ABC/2 or a semiautomated planimetric method. HE was defined as an ICH volume increase >33% or >6 mL from baseline within 72 hours. We included 500 patients (97 NOAC-ICH and 403 VKA-ICH). Median baseline ICH volume was 14.4 mL (interquartile range [IQR] 3.6-38.4) for NOAC-ICH vs 10.6 mL (IQR 4.0-27.9) for VKA-ICH ( = 0.78). We did not find any difference between NOAC-ICH and VKA-ICH for all-cause mortality within 90 days (33% for NOAC-ICH vs 31% for VKA-ICH [ = 0.64]; adjusted Cox hazard ratio (for NOAC-ICH vs VKA-ICH) 0.93 [95% confidence interval (CI) 0.52-1.64] [ = 0.79]), the rate of HE (NOAC-ICH n = 29/48 [40%] vs VKA-ICH n = 93/140 [34%] [ = 0.45]), or functional outcome at hospital discharge (NOAC-ICH vs VKA-ICH odds ratio 0.47; 95% CI 0.18-1.19 [ = 0.11]). In our international collaborative multicenter pooled analysis, baseline ICH volume, hematoma expansion, 90-day mortality, and functional outcome were similar following NOAC-ICH and VKA-ICH.