دورية أكاديمية
Neuroimaging and clinical outcomes of oral anticoagulant associated ICH
| العنوان: | Neuroimaging and clinical outcomes of oral anticoagulant associated ICH |
|---|---|
| المؤلفون: | Tsivgoulis, G, Wilson, D, Katsanos, AH, Sargento-Freitas, J, Marques-Matos, C, Azevedo, E, Adachi, T, von der Brelie, C, Aizawa, Y, Abe, H, Tomita, H, Okumura, K, Hagii, J, Seiffge, DJ, Lioutas, V-A, Traenka, C, Varelas, P, Basir, G, Krogias, C, Purrucker, JC, Sharma, VK, Rizos, T, Mikulik, R, Sobowale, OA, Barlinn, K, Sallinen, H, Goyal, N, Yeh, S-J, Karapanayiotides, T, Wu, TY, Vadikolias, K, Ferrigno, M, Hadjigeorgiou, G, Houben, R, Giannopoulos, S, Schreuder, FHBM, Chang, JJ, Perry, LA, Mehdorn, M, Marto, J-P, Pinho, J, Tanaka, J, Boulanger, M, Salman, RA-S, Jäger, HR, Shakeshaft, C, Yakushiji, Y, Choi, PMC, Staals, J, Cordonnier, C, Jeng, J-S, Veltkamp, R, Dowlatshahi, D, Engelter, ST, Parry-Jones, AR, Meretoja, A, Mitsias, P, Alexandrov, AV, Ambler, G, Werring, DJ |
| المصدر: | Annals of Neurology , 84 (5) pp. 694-704. (2018) |
| سنة النشر: | 2018 |
| المجموعة: | University College London: UCL Discovery |
| مصطلحات موضوعية: | haematoma volume, individual patient data meta-analysis, intracerebral haemorrhage, non-vitamin K antagonist, outcome, vitamin K antagonist |
| الوصف: | OBJECTIVE: Whether intracerebral haemorrhage (ICH) associated with non-vitamin K antagonist oral anticoagulants (NOAC-ICH) has a better outcome compared to ICH associated with vitamin-K antagonists (VKA-ICH) is uncertain. METHODS: We performed a systematic review and individual patient data meta-analysis of cohort studies comparing clinical and radiological outcomes between NOAC-ICH and VKA-ICH patients. The primary outcome measure was 30-day all-cause mortality. All outcomes were assessed in multivariable regression analyses adjusted for age, sex, ICH location and intraventricular haemorrhage extension. RESULTS: We included 7 eligible studies comprising 219 NOAC-ICH and 831 VKA-ICH patients (mean age:77 years,52.5% females). The 30-day mortality was similar between NOAC-ICH and VKA-ICH (24.3% vs. 26.5%; HR=0.94, 95%CI: 0.67 to 1.31). However, in multivariable analyses adjusting for potential confounders, NOAC-ICH was associated with: lower admission National Institutes of Health Stroke Scale (NIHSS) score (linear regression coefficient=-2.83, 95%CI:-5.28 to -0.38); lower likelihood of severe stroke (NIHSS>10 points) on admission (OR=0.50, 95%CI: 0.30 to 0.84); and smaller baseline haematoma volume (linear regression coefficient=-0.24,95%CI:-0.47 to -0.16). The two groups did not differ in the likelihood of: baseline haematoma volume less than 30cm3 (OR=1.14, 95%CI: 0.81 to 1.62); haematoma expansion (OR=0.97, 95%CI: 0.63 to 1.48); in-hospital mortality (OR=0.73,95%CI: 0.49 to 1.11); functional status at discharge (common OR=0.78, 95%CI: 0.57 to 1.07); or functional status at three months (common OR=1.03, 95%CI: 0.75 to 1.43). INTERPRETATION: Although functional outcome at discharge, one month or three months were comparable after NOAC-ICH and VKA-ICH, patients with NOAC-ICH had smaller baseline haematoma volumes and less severe acute stroke syndromes. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | text |
| اللغة: | English |
| العلاقة: | https://discovery.ucl.ac.uk/id/eprint/10057877/1/ana.25342.pdfTest; https://discovery.ucl.ac.uk/id/eprint/10057877Test/ |
| الإتاحة: | https://discovery.ucl.ac.uk/id/eprint/10057877/1/ana.25342.pdfTest https://discovery.ucl.ac.uk/id/eprint/10057877Test/ |
| حقوق: | open |
| رقم الانضمام: | edsbas.D4DC52BE |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |