The combination of warfarin use and the spot sign leads to detrimental outcomes in patients with intracerebral hematomas.
Clin Neurol Neurosurg
; 178: 20-24, 2019 03.
Article
de En
| MEDLINE
| ID: mdl-30682709
ABSTRACT
OBJECTIVES:
While warfarin use and the presence of the spot sign on computed tomography angiography are associated with a high frequency of hematoma enlargement and high mortality among patients with intracerebral hematomas (ICHs), the effects of various combinations of warfarin use and/or the spot sign have never been clarified. The combinations of both or either of warfarin use and/or the spot sign were used to investigate their relationships with hematoma enlargement and mortality before the introduction of prothrombin complex concentrate (PCC) treatment. PATIENTS ANDMETHODS:
Consecutive patients with ICHs admitted within 6 h of onset from 2009 to 2017 were investigated.RESULTS:
Of 703 eligible patients, the combinations of warfarin use and spot sign-present and of warfarin use and spot sign-absent were seen in 23 (3.3%) and 35 patients (5.0%), respectively. The combination of warfarin use and spot sign-present was a predictor of hematoma enlargement (p < 0.05). In regard to mortality (13.5% for all patients), mortality with the combination of warfarin use and spot sign-present was 52.2%, which was significantly higher than in the 3 other groups. Multivariate analysis showed that the combination of warfarin use and spot sign-present was a significant predictor of mortality (p < 0.05).CONCLUSION:
Warfarin users with ICHs showing spot signs, who accounted for approximately 40% of ICH patients with warfarin use, showed a high frequency of hematoma enlargement and high mortality. This group was regarded as high-risk patients and should be considered candidates for prompt administration of PCC.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Warfarine
/
Hémorragie cérébrale
/
Anticoagulants
Type d'étude:
Prognostic_studies
Limites:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Langue:
En
Journal:
Clin Neurol Neurosurg
Année:
2019
Type de document:
Article
Pays d'affiliation:
Japon