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Conference Paper: Warfarin associated intracerebral haemorrhage in Hong Kong
Title | Warfarin associated intracerebral haemorrhage in Hong Kong |
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Authors | |
Issue Date | 2014 |
Publisher | American 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? |
Abstract | OBJECTIVE: 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. |
Description | P7: 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 Identifier | http://hdl.handle.net/10722/198185 |
DC Field | Value | Language |
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dc.contributor.author | Teo, KC | en_US |
dc.contributor.author | Mahboobani, NR | en_US |
dc.contributor.author | Lee, R | en_US |
dc.contributor.author | Siu, DCW | en_US |
dc.contributor.author | Cheung, R | en_US |
dc.contributor.author | Ho, SL | en_US |
dc.contributor.author | Lau, GKK | en_US |
dc.contributor.author | Chan, KH | en_US |
dc.date.accessioned | 2014-06-25T02:51:56Z | - |
dc.date.available | 2014-06-25T02:51:56Z | - |
dc.date.issued | 2014 | en_US |
dc.identifier.citation | The 66th Annual Meeting of the American Academy of Neurology (AAN 2014), Philadelphia, PA., 26 April-3 May 2014. | en_US |
dc.identifier.uri | http://hdl.handle.net/10722/198185 | - |
dc.description | P7: Poster Session 7: Cerebrovascular Disease and Interventional Neurology: Intracerebral Hemorrhage Outcome and Mortality: abstract no. P7.142 | - |
dc.description | I2: INS Poster Session: New Antithrombotic Agents for Stroke Prevention: abstract no. I2-1.009 | - |
dc.description.abstract | OBJECTIVE: 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.language | eng | en_US |
dc.publisher | American Academy of Neurology (AAN). | - |
dc.relation.ispartof | Annual Meeting of the American Academy of Neurology, AAN 2014 | en_US |
dc.title | Warfarin associated intracerebral haemorrhage in Hong Kong | en_US |
dc.type | Conference_Paper | en_US |
dc.identifier.email | Lee, R: raymand@hku.hk | en_US |
dc.identifier.email | Siu, DCW: cwdsiu@hkucc.hku.hk | en_US |
dc.identifier.email | Cheung, R: rtcheung@hku.hk | en_US |
dc.identifier.email | Ho, SL: slho@hku.hk | en_US |
dc.identifier.email | Lau, GKK: gkklau@hku.hk | en_US |
dc.identifier.email | Chan, KH: koonho@hku.hk | - |
dc.identifier.authority | Siu, DCW=rp00534 | en_US |
dc.identifier.authority | Cheung, R=rp00434 | en_US |
dc.identifier.authority | Ho, SL=rp00240 | en_US |
dc.identifier.authority | Lau, GKK=rp01499 | en_US |
dc.identifier.authority | Chan, KH=rp00537 | en_US |
dc.identifier.hkuros | 229266 | en_US |
dc.publisher.place | United States | - |