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Conference Paper: Warfarin associated intracerebral haemorrhage in Hong Kong

TitleWarfarin associated intracerebral haemorrhage in Hong Kong
Authors
Issue Date2014
PublisherAmerican Academy of Neurology (AAN).
Citation
The 66th Annual Meeting of the American Academy of Neurology (AAN 2014), Philadelphia, PA., 26 April-3 May 2014. How to Cite?
AbstractOBJECTIVE: To study the clinical features and factors that predict clinical outcome of Chinese patients with warfarin-associated intracerebral hemorrhage (WICH). BACKGROUND: WICH is a serious neurological condition associated with significant mortality and morbidity. Data of WICH in Chinese is lacking seriously. DESIGN/METHODS: Medical records of patients with WICH admitted to our hospital from July 2001 till June 2010 were reviewed. Good outcome was defined as modified Rankin Scale (mRS) 0-3 and poor outcome was defined as mRS 4-6. RESULTS: 51 patients with WICH were identified. The mean age was 74.3±10.5 years. The mean INR on presentation was 2.9±1.0. The median ICH volume was 23.3(10.4-59.3) ml. The mortality rate at 30 day and 3-6 months were 58.0% and 62.0% respectively. Multivariate logistic analysis revealed that an initial ICH volume of >20ml (OR 34.4; 95% confidence interval (CI): 1.2-956.8, p=0.037) and presence of intraventricular hemorrhage (OR 22.9; 95% CI:1.1-494.2, p=0.046) were independently associated with poor outcome. Supratherapeutic INR (INR >3.0) (p=0.724) and complete correction of INR within 24 hours after admission (p=0.486) were not independent predictors of poor outcome. The median ICH volumes did not differ between INR groups (18.2(9.4 - 61.1) ml for INR≤3 vs. 27.3(13.7 - 58.5) ml for INR>3, p=0.718). Neurological deterioration was documented in 19 (63.3%) of the 30 patients included in a smaller sub-cohort, and was associated with poor neurological outcome (OR 20.7; 95% CI:1.5-284.4, p=0.027). Warfarin was resumed in 7 of the 20 survivors. There were 2 episodes of recurrent WICH and 1 episode of ischemic stroke during a mean follow-up duration of 5.4 years. In survivors who were not resumed on warfarin, there were 2 episodes of recurrent ICH and 12 episodes of ischemic vascular events during a mean follow-up duration of 2.6 years. CONCLUSIONS: WICH is a serious complication of warfarin therapy with high mortality and morbidity. Initial ICH volume, presence of intraventricular hemorrhage and neurological deterioration are independent predictors of clinical outcome.
DescriptionP7: Poster Session 7: Cerebrovascular Disease and Interventional Neurology: Intracerebral Hemorrhage Outcome and Mortality: abstract no. P7.142
I2: INS Poster Session: New Antithrombotic Agents for Stroke Prevention: abstract no. I2-1.009
Persistent Identifierhttp://hdl.handle.net/10722/198185

 

DC FieldValueLanguage
dc.contributor.authorTeo, KCen_US
dc.contributor.authorMahboobani, NRen_US
dc.contributor.authorLee, Ren_US
dc.contributor.authorSiu, DCWen_US
dc.contributor.authorCheung, Ren_US
dc.contributor.authorHo, SLen_US
dc.contributor.authorLau, GKKen_US
dc.contributor.authorChan, KHen_US
dc.date.accessioned2014-06-25T02:51:56Z-
dc.date.available2014-06-25T02:51:56Z-
dc.date.issued2014en_US
dc.identifier.citationThe 66th Annual Meeting of the American Academy of Neurology (AAN 2014), Philadelphia, PA., 26 April-3 May 2014.en_US
dc.identifier.urihttp://hdl.handle.net/10722/198185-
dc.descriptionP7: Poster Session 7: Cerebrovascular Disease and Interventional Neurology: Intracerebral Hemorrhage Outcome and Mortality: abstract no. P7.142-
dc.descriptionI2: INS Poster Session: New Antithrombotic Agents for Stroke Prevention: abstract no. I2-1.009-
dc.description.abstractOBJECTIVE: To study the clinical features and factors that predict clinical outcome of Chinese patients with warfarin-associated intracerebral hemorrhage (WICH). BACKGROUND: WICH is a serious neurological condition associated with significant mortality and morbidity. Data of WICH in Chinese is lacking seriously. DESIGN/METHODS: Medical records of patients with WICH admitted to our hospital from July 2001 till June 2010 were reviewed. Good outcome was defined as modified Rankin Scale (mRS) 0-3 and poor outcome was defined as mRS 4-6. RESULTS: 51 patients with WICH were identified. The mean age was 74.3±10.5 years. The mean INR on presentation was 2.9±1.0. The median ICH volume was 23.3(10.4-59.3) ml. The mortality rate at 30 day and 3-6 months were 58.0% and 62.0% respectively. Multivariate logistic analysis revealed that an initial ICH volume of >20ml (OR 34.4; 95% confidence interval (CI): 1.2-956.8, p=0.037) and presence of intraventricular hemorrhage (OR 22.9; 95% CI:1.1-494.2, p=0.046) were independently associated with poor outcome. Supratherapeutic INR (INR >3.0) (p=0.724) and complete correction of INR within 24 hours after admission (p=0.486) were not independent predictors of poor outcome. The median ICH volumes did not differ between INR groups (18.2(9.4 - 61.1) ml for INR≤3 vs. 27.3(13.7 - 58.5) ml for INR>3, p=0.718). Neurological deterioration was documented in 19 (63.3%) of the 30 patients included in a smaller sub-cohort, and was associated with poor neurological outcome (OR 20.7; 95% CI:1.5-284.4, p=0.027). Warfarin was resumed in 7 of the 20 survivors. There were 2 episodes of recurrent WICH and 1 episode of ischemic stroke during a mean follow-up duration of 5.4 years. In survivors who were not resumed on warfarin, there were 2 episodes of recurrent ICH and 12 episodes of ischemic vascular events during a mean follow-up duration of 2.6 years. CONCLUSIONS: WICH is a serious complication of warfarin therapy with high mortality and morbidity. Initial ICH volume, presence of intraventricular hemorrhage and neurological deterioration are independent predictors of clinical outcome.-
dc.languageengen_US
dc.publisherAmerican Academy of Neurology (AAN).-
dc.relation.ispartofAnnual Meeting of the American Academy of Neurology, AAN 2014en_US
dc.titleWarfarin associated intracerebral haemorrhage in Hong Kongen_US
dc.typeConference_Paperen_US
dc.identifier.emailLee, R: raymand@hku.hken_US
dc.identifier.emailSiu, DCW: cwdsiu@hkucc.hku.hken_US
dc.identifier.emailCheung, R: rtcheung@hku.hken_US
dc.identifier.emailHo, SL: slho@hku.hken_US
dc.identifier.emailLau, GKK: gkklau@hku.hken_US
dc.identifier.emailChan, KH: koonho@hku.hk-
dc.identifier.authoritySiu, DCW=rp00534en_US
dc.identifier.authorityCheung, R=rp00434en_US
dc.identifier.authorityHo, SL=rp00240en_US
dc.identifier.authorityLau, GKK=rp01499en_US
dc.identifier.authorityChan, KH=rp00537en_US
dc.description.naturelink_to_OA_fulltext-
dc.identifier.hkuros229266en_US
dc.publisher.placeUnited States-

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