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Prognosis of Intrac...
Prognosis of Intracerebral Hemorrhage Related to Antithrombotic Use : An Observational Study From the Swedish Stroke Register (Riksstroke)
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- Apostolaki-Hansson, Trine (författare)
- Skåne University Hospital
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- Ullberg, Teresa (författare)
- Lund University,Lunds universitet,Stroke policy och kvalitetsregisterforskning,Forskargrupper vid Lunds universitet,Stroke policy and quality register research,Lund University Research Groups,Skåne University Hospital
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- Pihlsgård, Mats (författare)
- Lund University,Lunds universitet,Perinatal och kardiovaskulär epidemiologi,Forskargrupper vid Lunds universitet,Perinatal and cardiovascular epidemiology,Lund University Research Groups,Skåne University Hospital
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- Norrving, Bo (författare)
- Lund University,Lunds universitet,Stroke policy och kvalitetsregisterforskning,Forskargrupper vid Lunds universitet,Stroke policy and quality register research,Lund University Research Groups,Skåne University Hospital
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- Petersson, Jesper (författare)
- Lund University,Lunds universitet,Stroke policy och kvalitetsregisterforskning,Forskargrupper vid Lunds universitet,Stroke policy and quality register research,Lund University Research Groups,Skåne University Hospital
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(creator_code:org_t)
- 2021
- 2021
- Engelska 9 s.
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Ingår i: Stroke. - 1524-4628. ; 52:3, s. 966-974
- Relaterad länk:
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http://dx.doi.org/10...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- BACKGROUND AND PURPOSE: To date, large studies comparing mortality and functional outcome of intracerebral hemorrhage (ICH) during oral anticoagulant (OAC), antiplatelet, and nonantithrombotic use are few and show discrepant results. METHODS: We used data on 13 291 patients with ICH registered in Riksstroke between 2012 and 2016 to compare 90-day mortality and functional outcome following OAC-related ICH (n=2300), antiplatelet-related ICH (n=3637), and nonantithrombotic ICH (n=7354). Univariable and multivariable Cox regression analyses, with adjustment for relevant confounders, were used to compare 90-day mortality. Early (≤24 hours and 1-7 days) and late (8-90 days) mortality was also studied in subgroup analyses. Univariable and multivariable 90-day functional outcome, based on self-reported modified Rankin Scale, was determined using logistic regression. RESULTS: Patients with antithrombotic treatment were more often prestroke dependent, older, and had a larger comorbidity burden compared with patients without antithrombotic treatment. At 90 days, antiplatelet and OAC were associated with an increased death rate in multivariable analysis (antiplatelet ICH: hazard ratio, 1.23 [95% CI, 1.14-1.33]; OAC ICH: hazard ratio, 1.40 [95% CI, 1.26-1.57]) compared with nonantithrombotic ICH (reference). OAC ICH and antiplatelet ICH were associated with higher risk of early mortality (≤24 hours: OAC ICH: hazard ratio, 1.93 [95% CI, 1.57-2.38]; antiplatelet ICH: hazard ratio, 1.32 [95% CI, 1.13-1.54]). In multivariable analysis, the odds ratios for the association of antiplatelet and OAC treatment on functional dependency (modified Rankin Scale score, 3-5) at 90 days were nonsignificant (antiplatelet: odds ratio, 1.07 [95% CI, 0.92-1.24]; OAC: odds ratio, 0.96 [95% CI, 0.76-1.22]). CONCLUSIONS: In this large observational study, we found that 90-day mortality outcome was worse not only in OAC ICH but also in antiplatelet ICH, compared with patients with nonantithrombotic ICH. Antiplatelet ICH is common and is a serious condition with poor clinical outcome. Further studies are, therefore, warranted in determining the appropriate clinical management of these patients.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- anticoagulants
- cerebral hemorrhage
- mortality
- stroke
- survival
Publikations- och innehållstyp
- art (ämneskategori)
- ref (ämneskategori)
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