Document Detail


Modifiable risk factors for intracerebral hemorrhage: study of anticoagulated patients.
MedLine Citation:
PMID:  18697976     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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:
Elana C Fric-Shamji; Mohammed F Shamji; James Cole; Brien G Benoit
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Canadian family physician Médecin de famille canadien     Volume:  54     ISSN:  1715-5258     ISO Abbreviation:  Can Fam Physician     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-08-13     Completed Date:  2008-11-04     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0120300     Medline TA:  Can Fam Physician     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  1138-1139, 139.e1-4     Citation Subset:  IM    
Affiliation:
efric@alumni.uottawa.ca
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MeSH Terms
Descriptor/Qualifier:
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:
0/Anticoagulants; 81-81-2/Warfarin
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