Reported antiplatelet use influences long-term outcome independently in deep intracerebral hemorrhage.

Abstract:

BACKGROUND:Recent studies have focused on antiplatelet (AP) use in intracerebral hemorrhage (ICH) patients. Several outcome predictors have been debated, but influences on mortality and outcome still remain controversial, especially for different ICH locations. OBJECTIVE:To investigate the characteristics and functional outcome of ICH patients with reported regular AP use according to hemorrhage locations. METHODS:This retrospective analysis included 210 consecutive spontaneous ICH patients. Clinical data including the preadmission status, initial presentation, neuroradiological data, treatment, and outcome were evaluated. Analyses were calculated for AP use vs non-AP use according to hematoma locations, and multivariate models were calculated for hematoma expansion and unfavorable (modified Rankin Scale = 4-6) long-term functional outcome (at 1 year). RESULTS:For all AP users ICH volume was significantly larger, 27.7 mL (interquartile range 7.4-66.1) vs 16.8 mL (interquartile range 4.2-44.7); (P = .032). Analyses showed an increased mortality for AP users at 90 days and 1 year (P = .036; P = .008). Multivariately, for all ICH patients, prior AP use was independently associated with hematoma expansion (odds ratio [OR] 3.61; P = .026) and poorer functional outcome at 1 year (OR 3.82, P = .035). In deep ICH patients, AP use was an independent predictor of an unfavorable functional outcome at 1 year (OR 4.75, P = .048). CONCLUSION:Hematoma expansion and more frequent unfavorable long-term functional outcome were independently associated with prior AP use for all patients, and in deep ICH patients AP use was an independent predictor of an unfavorable long-term functional outcome.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Kuramatsu JB,Mauer C,Kiphuth IC,Lücking H,Kloska SP,Köhrmann M,Huttner HB

doi

10.1227/NEU.0b013e3182311266

subject

Has Abstract

pub_date

2012-02-01 00:00:00

pages

342-50; discussion 350

issue

2

eissn

0148-396X

issn

1524-4040

journal_volume

70

pub_type

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