Document Detail


Effect of aspirin and warfarin on early survival after intracerebral haemorrhage.
MedLine Citation:
PMID:  18297333     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: To determine whether taking aspirin or warfarin at the time of an intracerebral haemorrhage (ICH) has an independent effect on early survival. METHODS: All people with ICH presenting in Christchurch, New Zealand over a three-year period were identified. Independent predictors of mortality at 7, 14 and 28 days were calculated using binary logistic regression. RESULTS: Two hundred and fifty three cases were identified. Unadjusted 28-day mortality was 43% overall, but 53 % for warfarin associated ICH and 43% for patients taking aspirin. Haemorrhage volume, haemorrhage location, intraventricular spread and the use of warfarin were all independently and significantly associated with mortality at all three time intervals (7, 14 and 28 days). The effect of warfarin was apparent despite similar volumes of bleed in each group. Aspirin was not associated with increased early mortality. Increasing age was also an independent predictor associated with death at 28 days. INTERPRETATION: Use of warfarin (but not aspirin) immediately prior to ICH was independently associated with increased mortality, after controlling for comorbidities. Thus therapeutic efforts to rapidly reverse the warfarin induced coagulopathy may be justified to lower mortality.
Authors:
H Carl Hanger; Valerie J Fletcher; Tim J Wilkinson; Allan J Brown; Chris M Frampton; Richard Sainsbury
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Publication Detail:
Type:  Journal Article     Date:  2008-02-26
Journal Detail:
Title:  Journal of neurology     Volume:  255     ISSN:  0340-5354     ISO Abbreviation:  J. Neurol.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-03-26     Completed Date:  2008-05-28     Revised Date:  2010-03-23    
Medline Journal Info:
Nlm Unique ID:  0423161     Medline TA:  J Neurol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  347-52     Citation Subset:  IM    
Affiliation:
Older Persons Health, The Princess Margaret Hospital, 800, Christchurch, New Zealand. carl.hanger@cdhb.govt.nz
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Aged, 80 and over
Anticoagulants / adverse effects,  therapeutic use*
Aspirin / adverse effects,  therapeutic use*
Brain / pathology
Cerebral Hemorrhage / drug therapy*,  mortality*,  pathology
Female
Humans
Logistic Models
Male
Middle Aged
Neurosurgical Procedures
Platelet Aggregation Inhibitors / adverse effects,  therapeutic use*
Prognosis
Survival
Time Factors
Warfarin / adverse effects,  therapeutic use*
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Platelet Aggregation Inhibitors; 50-78-2/Aspirin; 81-81-2/Warfarin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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