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Mortality in patients with intracerebral hemorrhage associated with antiplatelet agents, oral anticoagulants or no antithrombotic therapy
- Source :
- European journal of internal medicine. 75
- Publication Year :
- 2019
-
Abstract
- The association between preceding treatment with antiplatelet agents (APs), vitamin K antagonists (VKAs) or direct oral anticoagulants (DOACs) and mortality after intracerebral hemorrhage (ICH) remains unclear. The aim of this multicenter, prospective cohort study was to assess the risk for death after ICH in consecutive patients who were on treatment with APs, VKAs, DOACs, or no antithrombotic agent. The primary outcome was in-hospital death by day 30. ICH volume at admission and volume expansion were centrally assessed. Out of 598 study patients, in-hospital death occurred in 21% of patients who were on treatment with APs, 25% with VKAs, 30% with DOACs, and 13% with no antithrombotics. Crude death rate was higher in patients on antithrombotics as compared to patients receiving no antithrombotic agent. At multivariate analysis, age (HR 1.07; 95% CI 1.04-1.10), previous stroke (HR 1.83; 95% CI 1.14-2.93), GCS ≤8 at admission (HR 6.06; 95% CI 3.16-9.74) and GCS 9-12 (HR 3.38; 95% CI 1.81-6.33) were independent predictors of death. Treatment with APs (HR 1.29; 95% CI 0.61-2.76), VKAs (HR 1.42; 95% CI 0.70-2.88) or DOACs (HR 1.28; 95% CI 0.61-2.73) were not predictors of death in the overall study population, in non-trauma associated ICH as well as when GCS was not included in the model. ICH volume and volume expansion were independent predictors of death. In conclusion, preceding treatment with antithrombotic is associated with the severity of ICH. Age, previous stroke and clinical severity at presentation were independent predictors of in-hospital death in patients with ICH.
- Subjects :
- medicine.medical_specialty
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
Hematoma
Fibrinolytic Agents
Internal medicine
Antithrombotic
Internal Medicine
medicine
Humans
In patient
cardiovascular diseases
030212 general & internal medicine
Prospective Studies
Mortality
Prospective cohort study
Stroke
Cerebral Hemorrhage
Retrospective Studies
Intracerebral hemorrhage
business.industry
Mortality rate
Antiplatelet agents
Anticoagulants
Cerebral hemorrhage
medicine.disease
Population study
business
Platelet Aggregation Inhibitors
Subjects
Details
- ISSN :
- 18790828
- Volume :
- 75
- Database :
- OpenAIRE
- Journal :
- European journal of internal medicine
- Accession number :
- edsair.doi.dedup.....6d5a44112e7dc43c1b224f4a911a2646