Document Detail


Enlargement of acute intracerebral hematomas in patients on long-term warfarin treatment.
MedLine Citation:
PMID:  20203487     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The relationship between warfarin administration and the frequent development of enlarged hematomas in patients with acute intracerebral hemorrhage (ICH) is controversial. The present study was carried out to examine this issue. METHODS: This study reviewed 41 patients with nontraumatic ICH within 24 h after stroke onset from 1999 to 2003 who received long-term warfarin treatment (29 men and 12 women, 70 +/- 12 years old) and 323 patients who had not been on warfarin (177 men and 146 women, 66 +/- 13 years old). The hematoma volume (HV) on admission, final HV, frequency of hematoma enlargement (HE) and other background characteristics were investigated. RESULTS: Both the HV on admission (p = 0.031) and final HV (p = 0.001) were larger in patients on warfarin than in those not receiving warfarin. HE occurred more frequently (p < 0.001), and mortality at 30 days or at discharge was higher (p = 0.003) in the warfarin group than in the control group. A multivariate adjusted logistic regression analysis showed that warfarin treatment (OR = 5.75, 95% CI = 2.41-13.8, p < 0.001), liver disease (OR = 2.59, 95% CI = 1.12-5.99, p = 0.026), and the National Institutes of Health Stroke Scale score (OR = 1.10, 95% CI = 1.04-1.15, p < 0.001, per 1-score increase) on admission were independently related to HE. CONCLUSIONS: Acute ICH in patients on long-term warfarin treatment appears to be associated with HE.
Authors:
Takahiro Kuwashiro; Masahiro Yasaka; Ryo Itabashi; Hideaki Nakagaki; Fumio Miyashita; Hiroaki Naritomi; Kazuo Minematsu
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-03-04
Journal Detail:
Title:  Cerebrovascular diseases (Basel, Switzerland)     Volume:  29     ISSN:  1421-9786     ISO Abbreviation:  Cerebrovasc. Dis.     Publication Date:  2010  
Date Detail:
Created Date:  2010-04-28     Completed Date:  2010-09-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9100851     Medline TA:  Cerebrovasc Dis     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  446-53     Citation Subset:  IM    
Copyright Information:
Copyright 2010 S. Karger AG, Basel.
Affiliation:
Cerebrovascular Division, Department of Medicine, National Cardiovascular Center, Osaka, Japan. tkuwashi@intmed2.med.kyushu-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Anticoagulants / adverse effects*,  therapeutic use
Case-Control Studies
Cerebral Hemorrhage / chemically induced*,  pathology,  radiography
Dose-Response Relationship, Drug
Female
Hematoma / chemically induced*,  pathology,  radiography
Humans
Logistic Models
Longitudinal Studies
Male
Middle Aged
Retrospective Studies
Stroke / drug therapy,  prevention & control
Tomography, X-Ray Computed
Warfarin / adverse effects*,  therapeutic use
Chemical
Reg. No./Substance:
0/Anticoagulants; 81-81-2/Warfarin

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


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