Oral anticoagulant treatment: risk factors involved in 500 intracranial hemorrhages
| Autor: | M. J. Peñarrubia, L. J. García-Frade, J. I. Tortosa, Alberto Cantalapiedra, E. Fernandez Fontecha, M. Ya ñez, M. Dueñas, O. Gutierrez |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.drug_class Intracranial Hemorrhages Risk Factors Internal medicine medicine Humans International Normalized Ratio Risk factor Aged Cerebral Hemorrhage Retrospective Studies Aged 80 and over Hematology business.industry Incidence (epidemiology) Anticoagulant Cancer Retrospective cohort study Middle Aged medicine.disease Surgery Spain Relative risk Female Cardiology and Cardiovascular Medicine business Platelet Aggregation Inhibitors |
| Zdroj: | Journal of thrombosis and thrombolysis. 22(2) |
| ISSN: | 0929-5305 |
| Popis: | Intracranial bleeding is the most severe complication caused by anticoagulant or antiplatelet treatment. The increasing use of this therapy, especially in older people, makes the balance between clinical benefit and bleeding risk an important consideration. A retrospective study of all consecutive 500 intracranial hemorrhages in the West Valladolid area, approximately 220,000 people, during the period 1998 to 2004, was performed. In relation to mortality, predisposing conditions were included, such as age, antithrombotic treatment, arterial hypertension, cancer, blood diseases, vascular malformations, and traumatisms. The incidence of intracranial hemorrhage was 310 per 100,000 per year with a mortality of 30%. Higher mortality was found in antiplatelet-treated patients (44.9%) than in anticoagulated patients (31.1%). This may be related to a different mean age of 78 vs. 71 years. Arterial hypertension was the most frequent risk factor (45.1% in nontreated patients, 60% anticoagulated, and 75.5% antiplatelet). The relative risk of intracranial bleeding in anticoagulated patients was 11.2 (p < 0.001) with an incidence of 0.03% and a median of 14 months since treatment began. The median INR was 3.3. In 40% of the patients the previous five controls were in range. Strict consideration of indications criteria joined to a better control of risk factors may avoid intracranial bleeding episodes. |
| Databáze: | OpenAIRE |
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