Effect of On-Admission Antiplatelet Treatment on Patients with Cerebral Hemorrhage
| Autor: | Giancarlo Agnelli, Maurizio Paciaroni, Paolo Milia, Francesco Palmerini, Valeria Caso, Andrea Alberti, Giorgio Silvestrelli, Michele Venti, Antonia M.R. Billeci, Sergio Biagini |
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| Rok vydání: | 2007 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Risk Assessment Severity of Illness Index Drug Administration Schedule Patient Admission Risk Factors Odds Ratio medicine Humans Hospital Mortality Prospective Studies Registries Coma Aged Cerebral Hemorrhage Aged 80 and over Secondary prevention business.industry Age Factors Recovery of Function Patient Discharge Surgery Stroke Treatment Outcome Italy Neurology Emergency medicine Female Neurology (clinical) medicine.symptom Cardiology and Cardiovascular Medicine business Platelet Aggregation Inhibitors |
| Zdroj: | Cerebrovascular Diseases. 24:215-218 |
| ISSN: | 1421-9786 1015-9770 |
| DOI: | 10.1159/000104480 |
| Popis: | Background: Antiplatelet treatment remains the first choice for primary and secondary prevention of vascular diseases; even so, expected benefits may be offset by risk of bleeding, particularly cerebral hemorrhage. The aim of this study was to assess the influence of antiplatelet treatment on clinical outcome at hospital discharge. Materials and Methods: Consecutive patients with first-ever stroke due to a primary intraparenchymal hemorrhage were prospectively identified over a 4-year period (2000–2003). Data on hemorrhage location, vascular risk factors, and antiplatelet and anticoagulant treatment were collected. At discharge, outcome was measured using the modified Rankin Scale (disabling stroke ≧3). Patients treated with anticoagulant therapy were excluded from the study. Results: Of 457 consecutive patients with cerebral hemorrhage, 94 (20.5%) had been taking antiplatelet agents. The treated patients (mean age for antiplatelet group 78.9 ± 9.0 years) were older than the nontreated patients (73.8 ± 9.4, p = 0.02). In-hospital mortality was 23.4 and 23.1% (p = n.s.) for patients who had been taking antiplatelet agents or no treatment. Poor outcome at discharge was found in 52.1 and 59.7% (p = n.s.), respectively. Univariate analysis showed that age and coma at admission were predictors of disability at discharge, but antiplatelet treatment was not. Additionally, age and coma were shown to be determinants of disability at discharge after multivariate analysis: OR 1.03 per year (95% CI: 1.018–1.049), p < 0.001 and OR 1.68 (95% CI: 1.138–2.503), p = 0.009, respectively. Conclusions: Hemorrhagic stroke continues to be responsible for a high percentage of disability and death. Furthermore, it was seen here that functional outcome was independent of previous antiplatelet treatment. |
| Databáze: | OpenAIRE |
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