the Effect of Anticoagulant Use on the Outcome of Patients with Spontaneous Intracerebral Hemorrhage

The Aim of the study: to evaluate the effect of anticoagulant usage on the outcome of patients with spontaneous intracerebral hemorrhage. Objectives of the study: 1) To evaluate demographic data and frequency of anticoagulant usage among patients with intracerebral hemorrhage; 2) To compare the dynamics of consciousness and intracerebral hemorrhage volume, localization based on CT imaging; 3) To analyze the most common ways of reverse coagulation disorders; 4) To compare intracerebral hemorrhage outcomes between anticoagulant and non-anticoagulant patients. Methodology: a retrospective exploratory – comparative analysis was performed. Case histories of 153 patients with intracerebral hemorrhage, stationed in Lithuanian University of Health Sciences Neurosurgery Intensive Care Unit were analyzed. Respective data of patients demographics (gender, age), type of anticoagulants, duration of hospitalization, localization and volume of intracerebral hemorrhage, midline dislocation, duration of mechanical ventilation, INR and SPA scores, patient outcome and scores of Glasgow outcome scale have been evaluated. Statistical analysis of the data was performed using ,,SPSS Statistics 22.0”, 95 % significance level p≤0,05 was chosen for significance evaluation. Results: Anticoagulants were used by 31 (20.3 %) patients with intracerebral hemorrhage. They were significantly more frequently used by elderly patients (p = 0.001), with 100 % being due to chronic AF. The use of anticoagulants had no significant effect on hematoma localization (p = 0.343), but effected lower state of consciousness upon arrival to intensive care unit (p = 0.038), higher haemorrhage volume (p = 0.05) and growth (p = 0,005). Correction of coagulation parameters was required in 28 anticoagulant patients. The most frequently used medicines were: vitamin K preparation (Vitacon), prothrombin complex concentrate (Octaplex) and fresh frozen plasma. The duration of hospitalization (p = 0.505) and mechanical ventilation (p = 0.548) were not significantly influenced by anticoagulants. Anticoagulant use was associated with higher patient mortality (p = 0.001) and lower Glasgow outcome scale scores (p = 0.001). Conclusions: 20.3 % of patients diagnosed with spontaneous intracerebral hemorrhage received anticoagulants. Their state of consciousness was significantly worse and the volume of the hematoma was higher. Vitamin K preparation, prothrombin complex concentrate and fresh-frozen plasma were the most commonly used for the reversal of coagulation parameters. Anticoagulant use has been associated with higher patient mortality and lower Glasgow outcome scale scores