Prognostic factors and analysis of mortality due to brain haemorrhages associated with vitamin K antagonist oral anticoagulants. Results from the TAC registry Factores pronósticos y análisis de la mortalidad de las hemorragias cerebrales asociadas a anticoagulantes orales antagonistas de la vitamina K. Resultados del Estudio TAC Registry
Zapata-Wainberg, Gustavo (Hospital Universitario de la Princesa (Madrid))
Quintas, S. (Hospital Universitario de la Princesa (Madrid))
Ximénez-Carrillo Rico, A. (Hospital Universitario de la Princesa (Madrid))
Benavente Fernández, L. (Hospital Universitario Central de Asturias)
Masjuan Vallejo, J. (Hospital Universitario Ramón y Cajal (Madrid))
Gállego Culleré, J. (Complejo Hospitalario de Navarra)
Freijó Guerrero, M.d.M. (Hospital de Basurto)
Egido, José Antonio (Hospital Universitario Clínico San Carlos (Madrid))
Gómez Sánchez, J.C. (Hospital Universitario de Salamanca)
Martínez-Domeño, Alejandro (Institut d'Investigació Biomèdica Sant Pau)
Purroy, F. (Hospital Universitari Arnau de Vilanova)
Vives Pastor, B. (Hospital Universitari Son Espases (Palma de Mallorca, Balears))
Rodríguez Yáñez, M. (Hospital Clínico Universitario (Santiago de Compostela, Galícia))
Vivancos, J. (Hospital Universitario de la Princesa (Madrid))
Universitat Autònoma de Barcelona

Data:	2018
Resum:	Intracranial haemorrhages (ICH) represent a severe and frequently lethal complication in patients treated with vitamin K antagonists (VKA). The purpose of our study is to describe the factors and clinical features associated with mortality in these patients. We conducted an observational, retrospective, multi-centre study based on prospective stroke registries in Spain. We included all patients admitted to neurology departments during a one-year period who met the following inclusion criteria: being 18 or older, having a diagnosis of ICH, and receiving VKA. Clinical and radiological parameters and 3-month outcomes were analysed. A total of 235 patients from 21 hospitals were included. Mortality rate at 90 days was 42. 6%. Bivariate analysis showed a significant association between death and the following factors: median NIHSS score at admission (5 [IQR = 9] vs 17 [IQR = 14] points, P<. 01) and presence of an extensive hemispheric haemorrhage (4. 9% vs 35%, P <. 01; χ). Extensive hemispheric haemorrhages, in addition to being the most lethal type, were associated with a shorter time to death (mean of 16. 5 days; 95% CI: 7. 1-26). A logistic regression model showed that only baseline NIHSS scores independently predicted death (odds ratio = 1. 13 [95% CI: 1. 08-1. 17] for each point in the scale). ICH in patients treated with VKA is associated with high mortality rates; mortality in these patients is mainly and independently associated with the clinical situation at stroke onset.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Castellà
Document:	Article ; recerca ; Versió publicada
Matèria:	Acenocoumarol ; Acenocumarol ; Anticoagulantes orales ; Hemorragia cerebral ; Intracranial haemorrhage ; Mortalidad ; Mortality ; Oral anticoagulants ; Warfarin ; Warfarina
Publicat a:	Neurología, Vol. 33 Núm. 7 (septiembre 2018) , p. 419-426, ISSN 1578-1968

DOI: 10.1016/j.nrl.2016.07.005
PMID: 27645776

8 p, 261.2 KB

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