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, Rico, AX, Fernandez, LB, Vallejo, JM, Cullere, JG, Guerrero, MDF, Egido, J, Sanchez, JCG, Domeno, AM, Purroy, F, Pastor, BV, Yanez, MR, Vivancos, J
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2018
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p3389
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=3389
Access Level:acceso abierto
Palabra clave:Intracranial haemorrhage
Oral anticoagulants
Acenocoumarol
Warfarin
Mortality
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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, SRico, AXFernandez, LBVallejo, JMCullere, JGGuerrero, MDFEgido, JSanchez, JCGDomeno, AMPurroy, FPastor, BVYanez, MRVivancos, JIntracranial haemorrhageOral anticoagulantsAcenocoumarolWarfarinMortalityIntroduction: 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. (C) 2016 Sociedad Espanola de Neurologia. Published by Elsevier Espana, S.L.U. All rights reservedELSEVIER ESPANA SLU2018info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=3389NEUROLOGIAISSN: 02134853ISSNe: 15781968reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Españolinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p33892026-06-14T12:41:47Z
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
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
Rico, AX
Fernandez, LB
Vallejo, JM
Cullere, JG
Guerrero, MDF
Egido, J
Sanchez, JCG
Domeno, AM
Purroy, F
Pastor, BV
Yanez, MR
Vivancos, J
author Zapata-Wainberg, G
author_facet Zapata-Wainberg, G
Quintas, S
Rico, AX
Fernandez, LB
Vallejo, JM
Cullere, JG
Guerrero, MDF
Egido, J
Sanchez, JCG
Domeno, AM
Purroy, F
Pastor, BV
Yanez, MR
Vivancos, J
author_role author
author2 Quintas, S
Rico, AX
Fernandez, LB
Vallejo, JM
Cullere, JG
Guerrero, MDF
Egido, J
Sanchez, JCG
Domeno, AM
Purroy, F
Pastor, BV
Yanez, MR
Vivancos, J
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Intracranial haemorrhage
Oral anticoagulants
Acenocoumarol
Warfarin
Mortality
topic Intracranial haemorrhage
Oral anticoagulants
Acenocoumarol
Warfarin
Mortality
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. (C) 2016 Sociedad Espanola de Neurologia. Published by Elsevier Espana, S.L.U. All rights reserved
publishDate 2018
dc.date.none.fl_str_mv 2018
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=3389
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=3389
dc.language.none.fl_str_mv Español
language_invalid_str_mv Español
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv ELSEVIER ESPANA SLU
publisher.none.fl_str_mv ELSEVIER ESPANA SLU
dc.source.none.fl_str_mv NEUROLOGIA
ISSN: 02134853
ISSNe: 15781968
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
repository.name.fl_str_mv
repository.mail.fl_str_mv
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