Patient factors associated with receiving reversal therapy in oral anticoagulant-related intracerebral hemorrhage.
Acta Neurol Scand
; 146(5): 590-597, 2022 Nov.
Article
en En
| MEDLINE
| ID: mdl-35974708
ABSTRACT
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.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Hemostáticos
/
Accidente Cerebrovascular
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
Acta Neurol Scand
Año:
2022
Tipo del documento:
Article
País de afiliación:
Suecia