| Modifiable risk factors for intracerebral hemorrhage: study of anticoagulated patients. | |
MedLine Citation:
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PMID: 18697976 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To determine whether there are modifiable risk factors for spontaneous intracerebral hemorrhage in patients receiving oral anticoagulation (OAC) therapy. DESIGN: Retrospective chart review between January 2002 and December 2004. PARTICIPANTS: A total of 315 consecutive patients presenting with spontaneous intracerebral hemorrhage. MAIN OUTCOME MEASURES: Overall mortality rates and surgical mortality rates, and discharge home compared with discharge to a long-term care facility. RESULTS: Of the 315 patients reviewed, 65 (20.6%) were receiving OAC therapy. Age, Glasgow Coma Scale score, and size of hematoma at presentation were similar in the 65 patients taking OAC and the 250 patients not taking it. Mean arterial pressure at presentation was significantly higher in the OAC group than in the control group (132 mm Hg vs 107 mm Hg, P = .01) as was the number of hematomas that progressed (52% vs 14%, P = .01). Overall mortality rates were higher in the OAC group than in the control group (52% vs 41%, P = .03) as were surgical mortality rates (62% vs 41%, P = .04). There were no significant differences in morbidity between the 2 groups. CONCLUSION: Mortality rates were higher among patients taking OAC therapy despite their having similarly sized hematomas at presentation. The higher initial mean arterial pressure among such patients has not been described previously in this setting. This higher mean arterial pressure correlates with the propensity of these patients' hematomas to expand after initial imaging and might partially mediate the mortality effect. In patients taking OAC, hypertension appears to be a modifiable risk factor for morbidity and mortality from intracerebral hemorrhage. |
Authors:
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Elana C Fric-Shamji; Mohammed F Shamji; James Cole; Brien G Benoit |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Canadian family physician Médecin de famille canadien Volume: 54 ISSN: 1715-5258 ISO Abbreviation: Can Fam Physician Publication Date: 2008 Aug |
Date Detail:
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Created Date: 2008-08-13 Completed Date: 2008-11-04 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 0120300 Medline TA: Can Fam Physician Country: Canada |
Other Details:
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Languages: eng Pagination: 1138-1139, 139.e1-4 Citation Subset: IM |
Affiliation:
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efric@alumni.uottawa.ca |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Oral Adult Age Distribution Aged Aged, 80 and over Anticoagulants / adverse effects*, therapeutic use Case-Control Studies Cerebral Hemorrhage / chemically induced*, epidemiology*, surgery Female Follow-Up Studies Glasgow Coma Scale Hematoma / chemically induced*, epidemiology*, surgery Humans Logistic Models Magnetic Resonance Imaging Male Middle Aged Multivariate Analysis Reference Values Retrospective Studies Risk Factors Severity of Illness Index Sex Distribution Survival Analysis Treatment Outcome Warfarin / administration & dosage, adverse effects |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants; 81-81-2/Warfarin |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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