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Effect of prothrombin complex concentrate on hematoma enlargement and clinical outcome in patients with anticoagulant-associated intracerebral hemorrhage.
- Source :
-
Cerebrovascular diseases (Basel, Switzerland) [Cerebrovasc Dis] 2011; Vol. 31 (2), pp. 170-6. Date of Electronic Publication: 2010 Dec 03. - Publication Year :
- 2011
-
Abstract
- Background: The present study was carried out to determine the effect of prothrombin complex concentrate (PCC) on hematoma enlargement (HE) and the early clinical outcome of intracerebral hemorrhage (ICH) patients on long-term warfarin treatment.<br />Methods: The medical records and computed tomography (CT) images of 50 consecutive ICH patients on long-term warfarin treatment (35 men, 15 women; 69 ± 12 years old) were reviewed. International normalized ratio (INR) values, frequency of HE and clinical outcome were compared between patients treated with and without PCC.<br />Results: INR values on admission were above 2.0 in 37 patients, of whom 19 were given PCC (PCC group) and 18 were not given PCC (control group). In these 37 patients, the frequency of HE (p = 0.017), the number of patients with a poor clinical outcome (modified Rankin Scale score ≥3 at 30 days or at discharge; p = 0.045) and in-hospital mortality (p = 0.042) were significantly higher in the control than in the PCC group. On multivariate logistic regression analysis with adjustment, PCC administration was independently associated (odds ratio 0.03, 95% confidence interval 0.00-0.63; p = 0.023) with a reduction in poor clinical outcome in ICH patients whose INR values were >2.0 on admission.<br />Conclusions: Immediate INR reversal with PCC may prevent HE and subsequent poor outcome.<br /> (Copyright © 2010 S. Karger AG, Basel.)
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Case-Control Studies
Cerebral Hemorrhage chemically induced
Cerebral Hemorrhage diagnostic imaging
Cerebral Hemorrhage mortality
Chi-Square Distribution
Female
Hematoma chemically induced
Hematoma diagnostic imaging
Hematoma mortality
Hospital Mortality
Humans
International Normalized Ratio
Japan
Logistic Models
Male
Middle Aged
Odds Ratio
Risk Assessment
Risk Factors
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Young Adult
Anticoagulants adverse effects
Blood Coagulation drug effects
Blood Coagulation Factors therapeutic use
Cerebral Hemorrhage drug therapy
Coagulants therapeutic use
Hematoma prevention & control
Warfarin adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1421-9786
- Volume :
- 31
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Cerebrovascular diseases (Basel, Switzerland)
- Publication Type :
- Academic Journal
- Accession number :
- 21135553
- Full Text :
- https://doi.org/10.1159/000321766