PMID- 16847397
OWN - NLM
STAT- MEDLINE
DCOM- 20061101
LR  - 20161124
IS  - 1015-9770 (Print)
IS  - 1015-9770 (Linking)
VI  - 22
IP  - 4
DP  - 2006
TI  - Intracranial haemorrhage in patients on antithrombotics: clinical presentation 
      and determinants of outcome in a prospective multicentric study in Italian 
      emergency departments.
PG  - 286-93
AB  - BACKGROUND: Intracranial haemorrhage (ICH) is the type of stroke associated with 
      the highest death rate, and about 30% of ICH occurs in patients on antithrombotic 
      treatment. This study relates clinical presentations and outcome of ICH patients 
      on oral anticoagulant (OA) or antiplatelet (AP) therapy admitted to 33 Italian 
      emergency departments (ED). METHODS: Consecutive patients were enrolled after 
      cranial computed tomography (CT). Primary outcome was the Modified Rankin Scale 
      (MRS) score at 3 months of follow-up. Common descriptive statistics were computed 
      after stratification for traumatic or spontaneous ICH and identification of the 
      anatomical location of bleeding. Multivariate logistic regression was used to 
      assess predictors of death. RESULTS: We recruited 434 patients on AP therapy and 
      232 on OA. There were 432 spontaneous and 234 traumatic ICH patients. The 
      proportions of AP and OA patients undergoing neurosurgery were 21.8 and 19.4%, 
      respectively, while < 30% underwent procoagulant medical treatment. At the 
      3-month follow-up, the case fatality rate was 42.0%, while disability or death 
      (MRS 3-6) was 68.1%. The odds ratio for death in OA versus AP patients was 2.63 
      (95% CI 1.73-4.00) in the whole population and 2.80 (95% CI 1.77-4.41) in 
      intraparenchymal event patients. Glasgow Coma Scale, age, spontaneous event and 
      anticoagulant use were found to be predictors of death both in traumatic and 
      spontaneous events. CONCLUSION: This study confirms the high prevalence of death 
      or disability in OA and AP patients with ICH. As far as the determinants of 
      mortality and disability are concerned, the results of this study might be useful 
      in the clinical management and allocation of resources in the ED setting. The 
      observed low use of procoagulant therapy highlights the need for ED educational 
      programmes to heighten the awareness of available and effective haemostatic 
      treatments.
CI  - Copyright 2006 S. Karger AG, Basel.
FAU - Baldi, G
AU  - Baldi G
FAU - Altomonte, F
AU  - Altomonte F
FAU - Altomonte, M
AU  - Altomonte M
FAU - Ghirarduzzi, A
AU  - Ghirarduzzi A
FAU - Brusasco, C
AU  - Brusasco C
FAU - Parodi, R C
AU  - Parodi RC
FAU - Ricciardi, A
AU  - Ricciardi A
FAU - Remollino, V
AU  - Remollino V
FAU - Spisni, V
AU  - Spisni V
FAU - Saporito, A
AU  - Saporito A
FAU - Caiazza, A
AU  - Caiazza A
FAU - Musso, G
AU  - Musso G
FAU - Cervellin, G
AU  - Cervellin G
FAU - Lamberti, S
AU  - Lamberti S
FAU - Buzzalino, M
AU  - Buzzalino M
FAU - De Giorgi, F
AU  - De Giorgi F
FAU - Del Prato, C
AU  - Del Prato C
FAU - Golinelli, M P
AU  - Golinelli MP
FAU - Gai, V
AU  - Gai V
FAU - Monsu, R
AU  - Monsu R
FAU - Gioffre', M
AU  - Gioffre' M
FAU - Giovanardi, D
AU  - Giovanardi D
FAU - Cattaneo, S
AU  - Cattaneo S
FAU - Frumento, F
AU  - Frumento F
FAU - Caporrella, A
AU  - Caporrella A
FAU - Re, G
AU  - Re G
FAU - De Iaco, F
AU  - De Iaco F
FAU - Bologna, G
AU  - Bologna G
FAU - Nocenti, F
AU  - Nocenti F
FAU - Lorenzi, C
AU  - Lorenzi C
FAU - Zoratti, R
AU  - Zoratti R
FAU - Sciolla, A
AU  - Sciolla A
FAU - Tiscione, V
AU  - Tiscione V
FAU - Pastorello, M
AU  - Pastorello M
FAU - Vandelli, A
AU  - Vandelli A
FAU - Villa, A
AU  - Villa A
FAU - Zanna, M
AU  - Zanna M
FAU - De Palma, A
AU  - De Palma A
FAU - Iorio, A
AU  - Iorio A
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
DEP - 20060717
PL  - Switzerland
TA  - Cerebrovasc Dis
JT  - Cerebrovascular diseases (Basel, Switzerland)
JID - 9100851
RN  - 0 (Anticoagulants)
RN  - 0 (Coagulants)
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Platelet Aggregation Inhibitors)
SB  - IM
MH  - Administration, Oral
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anticoagulants/administration & dosage/*therapeutic use
MH  - Coagulants/*therapeutic use
MH  - *Emergency Service, Hospital
MH  - Female
MH  - Fibrinolytic Agents/*therapeutic use
MH  - Humans
MH  - Intracranial Hemorrhages/*drug therapy/mortality/rehabilitation
MH  - Italy
MH  - Male
MH  - Middle Aged
MH  - Platelet Aggregation Inhibitors/*therapeutic use
MH  - Prospective Studies
MH  - Recovery of Function
MH  - Stroke/*drug therapy/mortality
MH  - Stroke Rehabilitation
MH  - Survival Analysis
MH  - Thromboembolism/drug therapy
EDAT- 2006/07/19 09:00
MHDA- 2006/11/02 09:00
CRDT- 2006/07/19 09:00
PHST- 2006/02/20 00:00 [received]
PHST- 2006/05/22 00:00 [accepted]
PHST- 2006/07/19 09:00 [pubmed]
PHST- 2006/11/02 09:00 [medline]
PHST- 2006/07/19 09:00 [entrez]
AID - 94604 [pii]
AID - 10.1159/000094604 [doi]
PST - ppublish
SO  - Cerebrovasc Dis. 2006;22(4):286-93. doi: 10.1159/000094604. Epub 2006 Jul 17.