Patient factors associated with receiving reversal therapy in oral anticoagulant-related intracerebral hemorrhage

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Apostolaki-Hansson, TrineLund University,Lunds universitet,Neurologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Stroke policy och kvalitetsregisterforskning,Forskargrupper vid Lunds universitet,Neurology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Stroke policy and quality register research,Lund University Research Groups,Skåne University Hospital (author)

Patient factors associated with receiving reversal therapy in oral anticoagulant-related intracerebral hemorrhage

Article/chapterEnglish2022

Publisher, publication year, extent ...

2022-08-16
Hindawi Limited,2022

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LIBRIS-ID:oai:lup.lub.lu.se:33796528-c21b-48b6-bf73-66e6da7c13a8
https://lup.lub.lu.se/record/33796528-c21b-48b6-bf73-66e6da7c13a8URI
https://doi.org/10.1111/ane.13685DOI

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Language:English
Summary in:English

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SwePubSwePub

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Subject category:art swepub-publicationtype
Subject category:ref swepub-contenttype

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Background: We aimed to describe baseline characteristics of patients with oral anticoagulant-related intracerebral hemorrhage (OAC-ICH) in Sweden and to identify predictive variables associated with receiving hemostatic treatment in the event of OAC-ICH. Methods: We performed an observational study based on data from Riksstroke and the Swedish Causes of Death Register to define baseline characteristics of patients with OAC-ICH who received reversal treatment compared with patients who did not receive reversal treatment during 2017–2019. Predictive analysis was performed using multivariable logistic regression to identify odds ratios for factors associated with receiving OAC reversal treatment. Results: We included 1902 patients ((n = 1146; OAC reversal treatment) (n = 756; no OAC reversal treatment)). The proportion of non-Vitamin K oral anticoagulant associated ICH (NOAC-ICH) patients who received reversal treatment was 48.4% and the proportion of Vitamin K antagonist-associated ICH (VKA-ICH) patients was 72.9%. Factors associated with a lower odds of receiving reversal treatment were increased age (OR = 0.98; 95% CI: 0.96–0.99), previous stroke (OR = 0.78; 95% CI: 0.62–0.98), comatose LOC (OR = 0.36;95%CI: 0.27–0.48; ref. = alert), pre-stroke dependency (OR = 0.72; 95% CI: 0.58–0.91), and NOAC treatment (OR = 0.34; 95% CI: 0.28–0.42). Care at a university hospital was not associated with higher odds of receiving reversal treatment compared to treatment at a county hospital. Conclusion: Treatment with a reversal agent following OAC-ICH was related to several patient factors including type of OAC drug. We identified that only 48% of patients with NOAC-ICH received hemostatic treatment despite an increase in these cases. Further studies are required to guide the use of reversal therapies more precisely, particularly in NOAC-ICH.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
intracerebral hemorrhage
non-vitamin K oral anticoagulant
oral anticoagulant drug
reversal therapy

Added entries (persons, corporate bodies, meetings, titles ...)

Ullberg, TeresaLund University,Lunds universitet,Neurologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Stroke policy och kvalitetsregisterforskning,Forskargrupper vid Lunds universitet,Stroke Imaging Research group,Neurology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Stroke policy and quality register research,Lund University Research Groups,Skåne University Hospital(Swepub:lu)med-tsu (author)
Norrving, BoLund University,Lunds universitet,Neurologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Klinisk strokeforskning,Forskargrupper vid Lunds universitet,Stroke policy och kvalitetsregisterforskning,Neurology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Clinical Stroke Research Group,Lund University Research Groups,Stroke policy and quality register research,Skåne University Hospital(Swepub:lu)neur-bno (author)
Petersson, JesperLund University,Lunds universitet,Neurologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Stroke policy och kvalitetsregisterforskning,Forskargrupper vid Lunds universitet,Neurology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Stroke policy and quality register research,Lund University Research Groups,Skåne University Hospital(Swepub:lu)neur-jpe (author)
Neurologi, LundSektion IV (creator_code:org_t)

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In:Acta Neurologica Scandinavica: Hindawi Limited146:5, s. 590-5970001-63141600-0404

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