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1.
World Neurosurg ; 95: 143-147, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27521729

RESUMO

OBJECTIVE/BACKGROUND: The use of antithrombotic medication (ATM) frequently is reported in patients with intracranial hemorrhage (ICH) and is associated with increased mortality. Unfortunately, ATMs sometimes are prescribed and/or used inappropriately. We sought to determine the rate of ATM misprescription/misuse among patients with ICH in a single-center retrospective study. METHODS: All patients admitted with ATM-related ICH in 1998-2014 were included. Charts were reviewed and demographic, clinical, and radiologic variables were recorded. The type of ATM, dose, and duration of treatment were analyzed critically. The adequacy of ATM prescription/use was assessed in light of the recommendations and guidelines of the American Heart Association, American Stroke Association, and French National Authority for Health, in effect at the time of admission. RESULTS: A total of 106 patients with mean age 68 years were identified. Aspirin (53.8%) was the most commonly used drug, followed by oral anticoagulants (31.1%) and clopidogrel (22.6%). In only 80 patients (75.5%), the use of ATM was in line with contemporary guidelines. In the remaining 26 (24.5%), the use of ATMs was inappropriate, including bad drug combination, wrong dose, poor indication, wrong drug class, and/or incorrect treatment duration. CONCLUSIONS: In this Lebanese cohort of patients with ICH, the 24.5% rate of ATM misprescription and/or misuse is highly alarming and the origin of this problem is likely multifactorial. Immediate measures should be undertaken, and efforts should be focused on regaining tight control of ATM prescription and fulfillment, ensuring good patient education, and offering more vigilant oversight on physician licensure.


Assuntos
Anticoagulantes/uso terapêutico , Prescrição Inadequada/estatística & dados numéricos , Hemorragias Intracranianas/epidemiologia , Inibidores da Agregação Plaquetária/uso terapêutico , Uso Indevido de Medicamentos sob Prescrição/estatística & dados numéricos , Acenocumarol/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Aspirina/uso terapêutico , Fibrilação Atrial/tratamento farmacológico , Hemorragia Cerebral/epidemiologia , Clopidogrel , Doença da Artéria Coronariana/tratamento farmacológico , Enoxaparina/uso terapêutico , Feminino , Fibrinolíticos/uso terapêutico , Humanos , Líbano/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Acidente Vascular Cerebral/tratamento farmacológico , Ticlopidina/análogos & derivados , Ticlopidina/uso terapêutico , Varfarina/uso terapêutico , Adulto Jovem
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