Prognostic factors and analysis of mortality due to brain haemorrhages associated with vitamin K antagonist oral anticoagulants. Results from the TAC registry
Introduction: Intracranial haemorrhages (ICH) represent a severe and frequently lethal complication in patients treated with vitamin K antagonists (VKA). The purpose of our study is to describe the factors and clinical features associated with mortality in these patients. Methods: We conducted an ob...
| Autores: | , , , , , , , , , , , , , , |
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| Tipo de recurso: | artículo |
| Fecha de publicación: | 2018 |
| País: | España |
| Institución: | Instituto de Salud Carlos III (ISCIII) |
| Repositorio: | Repisalud |
| Idioma: | español |
| OAI Identifier: | oai:repisalud.isciii.es:20.500.12105/22629 |
| Acceso en línea: | https://hdl.handle.net/20.500.12105/22629 |
| Access Level: | acceso abierto |
| Palabra clave: | Intracranial haemorrhage Oral anticoagulants Acenocoumarol Warfarin Mortality Accidente Cerebrovascular Femenino Vitamina K Hemorragia Cerebral Humanos Persona de Mediana Edad Adulto Joven Causas de Muerte Pronóstico Anciano Anciano de 80 o más Años Estudios Retrospectivos Adulto Anticoagulantes España Sistema de Registros |
| Sumario: | Introduction: Intracranial haemorrhages (ICH) represent a severe and frequently lethal complication in patients treated with vitamin K antagonists (VKA). The purpose of our study is to describe the factors and clinical features associated with mortality in these patients. Methods: We conducted an observational, retrospective, multi-centre study based on prospective stroke registries in Spain. We included all patients admitted to neurology departments during a one-year period who met the following inclusion criteria: being 18 or older, having a diagnosis of ICH, and receiving VKA. Clinical and radiological parameters and 3-month outcomes were analysed. Results: A total of 235 patients from 21 hospitals were included. Mortality rate at 90 days was 42.6%. Bivariate analysis showed a significant association between death and the following factors: median NIHSS score at admission (5 [IQR = 9] vs 17 [IQR = 14] points, P < .01) and presence of an extensive hemispheric haemorrhage (4.9% vs 35%, P < .01; chi(2)). Extensive hemispheric haemorrhages, in addition to being the most lethal type, were associated with a shorter time to death (mean of 16.5 days; 95% CI: 7.1-26). A logistic regression model showed that only baseline NIHSS scores independently predicted death (odds ratio =1.13 [95% CI: 1.08-1.17] for each point in the scale). Conclusion: ICH in patients treated with VKA is associated with high mortality rates; mortality in these patients is mainly and independently associated with the clinical situation at stroke onset. |
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