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...

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Autores: Zapata-Wainberg, G, Quintas, S, Ximenez-Carrillo Rico, A, Benavente Fernandez, L, Masjuan Vallejo, J, Gallego Cullere, Jaime, Freijo Guerrero, Maria del Mar, Egido, Jose, Gomez Sanchez, JC, Martinez Domeno, A, Purroy, F, Vives Pastor, Barbara, Rodriguez Yanez, M, Vivancos, J, Grp Investigadores Estudio TAC
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
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oai_identifier_str oai:repisalud.isciii.es:20.500.12105/22629
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spelling Prognostic factors and analysis of mortality due to brain haemorrhages associated with vitamin K antagonist oral anticoagulants. Results from the TAC registryZapata-Wainberg, GQuintas, SXimenez-Carrillo Rico, ABenavente Fernandez, LMasjuan Vallejo, JGallego Cullere, JaimeFreijo Guerrero, Maria del MarEgido, JoseGomez Sanchez, JCMartinez Domeno, APurroy, FVives Pastor, BarbaraRodriguez Yanez, MVivancos, JGrp Investigadores Estudio TACIntracranial haemorrhageOral anticoagulantsAcenocoumarolWarfarinMortalityAccidente CerebrovascularFemeninoVitamina KHemorragia CerebralHumanosPersona de Mediana EdadAdulto JovenCausas de MuertePronósticoAncianoAnciano de 80 o más AñosEstudios RetrospectivosAdultoAnticoagulantesEspañaSistema de RegistrosIntroduction: 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.Elsevier20242024-09-0620182018-09-0120182018-09-01research articlehttp://purl.org/coar/resource_type/c_2df8fbb1info:eu-repo/semantics/articlehttps://hdl.handle.net/20.500.12105/22629reponame:Repisaludinstname:Instituto de Salud Carlos III (ISCIII)Españolspaopen accesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:repisalud.isciii.es:20.500.12105/226292026-06-12T12:43:37Z
dc.title.none.fl_str_mv Prognostic factors and analysis of mortality due to brain haemorrhages associated with vitamin K antagonist oral anticoagulants. Results from the TAC registry
title Prognostic factors and analysis of mortality due to brain haemorrhages associated with vitamin K antagonist oral anticoagulants. Results from the TAC registry
spellingShingle Prognostic factors and analysis of mortality due to brain haemorrhages associated with vitamin K antagonist oral anticoagulants. Results from the TAC registry
Zapata-Wainberg, G
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
title_short Prognostic factors and analysis of mortality due to brain haemorrhages associated with vitamin K antagonist oral anticoagulants. Results from the TAC registry
title_full Prognostic factors and analysis of mortality due to brain haemorrhages associated with vitamin K antagonist oral anticoagulants. Results from the TAC registry
title_fullStr Prognostic factors and analysis of mortality due to brain haemorrhages associated with vitamin K antagonist oral anticoagulants. Results from the TAC registry
title_full_unstemmed Prognostic factors and analysis of mortality due to brain haemorrhages associated with vitamin K antagonist oral anticoagulants. Results from the TAC registry
title_sort Prognostic factors and analysis of mortality due to brain haemorrhages associated with vitamin K antagonist oral anticoagulants. Results from the TAC registry
dc.creator.none.fl_str_mv Zapata-Wainberg, G
Quintas, S
Ximenez-Carrillo Rico, A
Benavente Fernandez, L
Masjuan Vallejo, J
Gallego Cullere, Jaime
Freijo Guerrero, Maria del Mar
Egido, Jose
Gomez Sanchez, JC
Martinez Domeno, A
Purroy, F
Vives Pastor, Barbara
Rodriguez Yanez, M
Vivancos, J
Grp Investigadores Estudio TAC
author Zapata-Wainberg, G
author_facet Zapata-Wainberg, G
Quintas, S
Ximenez-Carrillo Rico, A
Benavente Fernandez, L
Masjuan Vallejo, J
Gallego Cullere, Jaime
Freijo Guerrero, Maria del Mar
Egido, Jose
Gomez Sanchez, JC
Martinez Domeno, A
Purroy, F
Vives Pastor, Barbara
Rodriguez Yanez, M
Vivancos, J
Grp Investigadores Estudio TAC
author_role author
author2 Quintas, S
Ximenez-Carrillo Rico, A
Benavente Fernandez, L
Masjuan Vallejo, J
Gallego Cullere, Jaime
Freijo Guerrero, Maria del Mar
Egido, Jose
Gomez Sanchez, JC
Martinez Domeno, A
Purroy, F
Vives Pastor, Barbara
Rodriguez Yanez, M
Vivancos, J
Grp Investigadores Estudio TAC
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv
dc.subject.none.fl_str_mv 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
topic 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
description 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.
publishDate 2018
dc.date.none.fl_str_mv 2018
2018-09-01
2018
2018-09-01
2024
2024-09-06
dc.type.none.fl_str_mv research article
http://purl.org/coar/resource_type/c_2df8fbb1
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/20.500.12105/22629
url https://hdl.handle.net/20.500.12105/22629
dc.language.none.fl_str_mv Español
spa
language_invalid_str_mv Español
language spa
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Repisalud
instname:Instituto de Salud Carlos III (ISCIII)
instname_str Instituto de Salud Carlos III (ISCIII)
reponame_str Repisalud
collection Repisalud
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,811543

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