https://scholars.lib.ntu.edu.tw/handle/123456789/590457
標題: | Outcome of intracerebral hemorrhage associated with different oral anticoagulants | 作者: | Wilson D. Seiffge D.J. Traenka C. Basir G. Purrucker J.C. Rizos T. Sobowale O.A. Sallinen H. SHIN-JOE YEH Wu T.Y. Ferrigno M. Houben R. Schreuder F.H.B.M. Perry L.A. Tanaka J. Boulanger M. Salman R.A.-S. J?ger H.R. Ambler G. Shakeshaft C. Yakushiji Y. Choi P.M.C. Staals J. Cordonnier C. JIANN-SHING JENG Veltkamp R. Dowlatshahi D. Engelter S.T. Parry-Jones A.R. Meretoja A. Werring D.J. |
公開日期: | 2017 | 卷: | 88 | 期: | 18 | 起(迄)頁: | 1693-1700 | 來源出版物: | Neurology | 摘要: | Objective: In an international collaborative multicenter pooled analysis, we compared mortality, functional outcome, intracerebral hemorrhage (ICH) volume, and hematoma expansion (HE) between non-vitamin K antagonist oral anticoagulation-related ICH (NOAC-ICH) and vitamin K antagonist-associated ICH (VKA-ICH). Methods: We compared all-cause mortality within 90 days for NOAC-ICH and VKA-ICH using a Cox proportional hazards model adjusted for age; sex; baseline Glasgow Coma Scale score, ICH location, and log volume; intraventricular hemorrhage volume; and intracranial surgery. We addressed heterogeneity using a shared frailty term. Good functional outcome was defined as discharge modified Rankin Scale score #2 and investigated in multivariable logistic regression. ICH volume was measured by ABC/2 or a semiautomated planimetric method. HE was defined as an ICH volume increase .33% or .6 mL from baseline within 72 hours. Results: We included 500 patients (97 NOAC-ICH and 403 VKA-ICH). Median baseline ICH volume was 14.4 mL (interquartile range [IQR] 3.6-38.4) for NOAC-ICH vs 10.6 mL (IQR 4.0-27.9) for VKAICH (p 5 0.78). We did not find any difference between NOAC-ICH and VKA-ICH for all-cause mortality within 90 days (33%for NOAC-ICH vs 31% for VKA-ICH [p 5 0.64]; adjusted Cox hazard ratio (for NOAC-ICH vs VKA-ICH) 0.93 [95% confidence interval (CI) 0.52-1.64] [p 5 0.79]), the rate of HE (NOAC-ICH n 5 29/48 [40%] vs VKA-ICH n 5 93/140 [34%] [p 5 0.45]), or functional outcome at hospital discharge (NOAC-ICH vs VKA-ICH odds ratio 0.47; 95% CI 0.18-1.19 [p 5 0.11]). Conclusions: In our international collaborative multicenter pooled analysis, baseline ICH volume, hematoma expansion, 90-day mortality, and functional outcome were similar following NOACICH and VKA-ICH. ? Copyright 2017 The Author(s). |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85019643481&doi=10.1212%2fWNL.0000000000003886&partnerID=40&md5=47fab4639df46df1c7fa8c908b02d98f https://scholars.lib.ntu.edu.tw/handle/123456789/590457 |
ISSN: | 283878 | DOI: | 10.1212/WNL.0000000000003886 | SDG/關鍵字: | anticoagulant agent; antivitamin K; apixaban; dabigatran; rivaroxaban; anticoagulant agent; vitamin K group; aged; anticoagulant therapy; anticoagulation; Article; atrial fibrillation; Australia; brain hemorrhage; brain surgery; Canada; female; Finland; frailty; France; functional assessment; Germany; Glasgow coma scale; hematoma; hospital discharge; human; international normalized ratio; Japan; major clinical study; male; mortality; mortality rate; multicenter study (topic); Netherlands; neurosurgery; outcome assessment; patient selection; priority journal; Rankin scale; retrospective study; Switzerland; Taiwan; United Kingdom; very elderly; antagonists and inhibitors; Cerebral Hemorrhage; clinical trial; comparative study; mortality; multicenter study; multivariate analysis; oral drug administration; pathology; proportional hazards model; prospective study; register; statistical model; survival analysis; treatment outcome; Administration, Oral; Anticoagulants; Cerebral Hemorrhage; Female; Glasgow Coma Scale; Humans; Logistic Models; Male; Multivariate Analysis; Proportional Hazards Models; Prospective Studies; Registries; Retrospective Studies; Survival Analysis; Treatment Outcome; Vitamin K |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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