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Volume and functional outcome of intracerebral hemorrhage according to oral anticoagulant type

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Volume and functional outcome of intracerebral hemorrhage according to oral anticoagulant type. / Wilson, Duncan; Charidimou, Andreas; Shakeshaft, Clare et al.
In: Neurology, Vol. 86, No. 4, 26.01.2016, p. 360-366.

Research output: Contribution to Journal/Magazine › Journal article › peer-review

Harvard

Wilson, D, Charidimou, A, Shakeshaft, C, Ambler, G, White, M, Cohen, H, Yousry, T, Al-Shahi Salman, R, Lip, GYH, Brown, MM, Jäger, HR, Werring, DJ, Emsley, H & CROMIS-2 collaborators 2016, 'Volume and functional outcome of intracerebral hemorrhage according to oral anticoagulant type', Neurology, vol. 86, no. 4, pp. 360-366. https://doi.org/10.1212/WNL.0000000000002310

APA

Wilson, D., Charidimou, A., Shakeshaft, C., Ambler, G., White, M., Cohen, H., Yousry, T., Al-Shahi Salman, R., Lip, G. Y. H., Brown, M. M., Jäger, H. R., Werring, D. J., Emsley, H., & CROMIS-2 collaborators (2016). Volume and functional outcome of intracerebral hemorrhage according to oral anticoagulant type. Neurology, 86(4), 360-366. https://doi.org/10.1212/WNL.0000000000002310

Vancouver

Wilson D, Charidimou A, Shakeshaft C, Ambler G, White M, Cohen H et al. Volume and functional outcome of intracerebral hemorrhage according to oral anticoagulant type. Neurology. 2016 Jan 26;86(4):360-366. Epub 2015 Dec 30. doi: 10.1212/WNL.0000000000002310

Author

Wilson, Duncan ; Charidimou, Andreas ; Shakeshaft, Clare et al. / Volume and functional outcome of intracerebral hemorrhage according to oral anticoagulant type. In: Neurology. 2016 ; Vol. 86, No. 4. pp. 360-366.

Bibtex

@article{1a9a9f6f99904418b0fbe34d2d1071a6,
title = "Volume and functional outcome of intracerebral hemorrhage according to oral anticoagulant type",
abstract = "OBJECTIVE: To compare intracerebral hemorrhage (ICH) volume and clinical outcome of non-vitamin K oral anticoagulants (NOAC)-associated ICH to warfarin-associated ICH.METHODS: In this multicenter cross-sectional observational study of patients with anticoagulant-associated ICH, consecutive patients with NOAC-ICH were compared to those with warfarin-ICH selected from a population of 344 patients with anticoagulant-associated ICH. ICH volume was measured by an observer blinded to clinical details. Outcome measures were ICH volume and clinical outcome adjusted for confounding factors.RESULTS: We compared 11 patients with NOAC-ICH to 52 patients with warfarin-ICH. The median ICH volume was 2.4 mL (interquartile range [IQR] 0.3-5.4 mL) for NOAC-ICH vs 8.9 mL (IQR 4.0-21.3 mL) for warfarin-ICH (p = 0.0028). In univariate linear regression, use of warfarin (difference in cube root volume 1.61; 95% confidence interval [CI] 0.69 to 2.53) and lobar ICH location (compared with nonlobar ICH; difference in cube root volume 1.52; 95% CI 2.20 to 0.85) were associated with larger ICH volumes. In multivariable linear regression adjusting for confounding factors (sex, hypertension, previous ischemic stroke, white matter disease burden, and premorbid modified Rankin Scale score [mRS]), warfarin use remained independently associated with larger ICH (cube root) volumes (coefficient 0.64; 95% CI 0.24 to 1.25; p = 0.042). Ordered logistic regression showed an increased odds of a worse clinical outcome (as measured by discharge mRS) in warfarin-ICH compared with NOAC-ICH: odds ratio 4.46 (95% CI 1.10 to 18.14; p = 0.037).CONCLUSIONS: In this small prospective observational study, patients with NOAC-associated ICH had smaller ICH volumes and better clinical outcomes compared with warfarin-associated ICH.",
keywords = "Aged, Aged, 80 and over, Anticoagulants, Cerebral Hemorrhage, Cross-Sectional Studies, Female, Humans, Male, Outcome Assessment (Health Care), Warfarin, Journal Article, Multicenter Study, Observational Study, Research Support, Non-U.S. Gov't",
author = "Duncan Wilson and Andreas Charidimou and Clare Shakeshaft and Gareth Ambler and Mark White and Hannah Cohen and Tarek Yousry and {Al-Shahi Salman}, Rustam and Lip, {Gregory Y H} and Brown, {Martin M} and J{\"a}ger, {Hans Rolf} and Werring, {David J} and Hedley Emsley and {CROMIS-2 collaborators}",
note = "{\textcopyright} 2015 American Academy of Neurology.",
year = "2016",
month = jan,
day = "26",
doi = "10.1212/WNL.0000000000002310",
language = "English",
volume = "86",
pages = "360--366",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

RIS

TY - JOUR

T1 - Volume and functional outcome of intracerebral hemorrhage according to oral anticoagulant type

AU - Wilson, Duncan

AU - Charidimou, Andreas

AU - Shakeshaft, Clare

AU - Ambler, Gareth

AU - White, Mark

AU - Cohen, Hannah

AU - Yousry, Tarek

AU - Al-Shahi Salman, Rustam

AU - Lip, Gregory Y H

AU - Brown, Martin M

AU - Jäger, Hans Rolf

AU - Werring, David J

AU - Emsley, Hedley

AU - CROMIS-2 collaborators

N1 - © 2015 American Academy of Neurology.

PY - 2016/1/26

Y1 - 2016/1/26

N2 - OBJECTIVE: To compare intracerebral hemorrhage (ICH) volume and clinical outcome of non-vitamin K oral anticoagulants (NOAC)-associated ICH to warfarin-associated ICH.METHODS: In this multicenter cross-sectional observational study of patients with anticoagulant-associated ICH, consecutive patients with NOAC-ICH were compared to those with warfarin-ICH selected from a population of 344 patients with anticoagulant-associated ICH. ICH volume was measured by an observer blinded to clinical details. Outcome measures were ICH volume and clinical outcome adjusted for confounding factors.RESULTS: We compared 11 patients with NOAC-ICH to 52 patients with warfarin-ICH. The median ICH volume was 2.4 mL (interquartile range [IQR] 0.3-5.4 mL) for NOAC-ICH vs 8.9 mL (IQR 4.0-21.3 mL) for warfarin-ICH (p = 0.0028). In univariate linear regression, use of warfarin (difference in cube root volume 1.61; 95% confidence interval [CI] 0.69 to 2.53) and lobar ICH location (compared with nonlobar ICH; difference in cube root volume 1.52; 95% CI 2.20 to 0.85) were associated with larger ICH volumes. In multivariable linear regression adjusting for confounding factors (sex, hypertension, previous ischemic stroke, white matter disease burden, and premorbid modified Rankin Scale score [mRS]), warfarin use remained independently associated with larger ICH (cube root) volumes (coefficient 0.64; 95% CI 0.24 to 1.25; p = 0.042). Ordered logistic regression showed an increased odds of a worse clinical outcome (as measured by discharge mRS) in warfarin-ICH compared with NOAC-ICH: odds ratio 4.46 (95% CI 1.10 to 18.14; p = 0.037).CONCLUSIONS: In this small prospective observational study, patients with NOAC-associated ICH had smaller ICH volumes and better clinical outcomes compared with warfarin-associated ICH.

AB - OBJECTIVE: To compare intracerebral hemorrhage (ICH) volume and clinical outcome of non-vitamin K oral anticoagulants (NOAC)-associated ICH to warfarin-associated ICH.METHODS: In this multicenter cross-sectional observational study of patients with anticoagulant-associated ICH, consecutive patients with NOAC-ICH were compared to those with warfarin-ICH selected from a population of 344 patients with anticoagulant-associated ICH. ICH volume was measured by an observer blinded to clinical details. Outcome measures were ICH volume and clinical outcome adjusted for confounding factors.RESULTS: We compared 11 patients with NOAC-ICH to 52 patients with warfarin-ICH. The median ICH volume was 2.4 mL (interquartile range [IQR] 0.3-5.4 mL) for NOAC-ICH vs 8.9 mL (IQR 4.0-21.3 mL) for warfarin-ICH (p = 0.0028). In univariate linear regression, use of warfarin (difference in cube root volume 1.61; 95% confidence interval [CI] 0.69 to 2.53) and lobar ICH location (compared with nonlobar ICH; difference in cube root volume 1.52; 95% CI 2.20 to 0.85) were associated with larger ICH volumes. In multivariable linear regression adjusting for confounding factors (sex, hypertension, previous ischemic stroke, white matter disease burden, and premorbid modified Rankin Scale score [mRS]), warfarin use remained independently associated with larger ICH (cube root) volumes (coefficient 0.64; 95% CI 0.24 to 1.25; p = 0.042). Ordered logistic regression showed an increased odds of a worse clinical outcome (as measured by discharge mRS) in warfarin-ICH compared with NOAC-ICH: odds ratio 4.46 (95% CI 1.10 to 18.14; p = 0.037).CONCLUSIONS: In this small prospective observational study, patients with NOAC-associated ICH had smaller ICH volumes and better clinical outcomes compared with warfarin-associated ICH.

KW - Aged

KW - Aged, 80 and over

KW - Anticoagulants

KW - Cerebral Hemorrhage

KW - Cross-Sectional Studies

KW - Female

KW - Humans

KW - Male

KW - Outcome Assessment (Health Care)

KW - Warfarin

KW - Journal Article

KW - Multicenter Study

KW - Observational Study

KW - Research Support, Non-U.S. Gov't

U2 - 10.1212/WNL.0000000000002310

DO - 10.1212/WNL.0000000000002310

M3 - Journal article

C2 - 26718576

VL - 86

SP - 360

EP - 366

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 4

ER -