Själander A, Engström G, Berntorp E, Svensson P
Department of Coagulation Disorders, Malmö University Hospital, University of Lund, Lund, Sweden.
J Intern Med. 2003 Nov;254(5):434-8. doi: 10.1046/j.1365-2796.2003.01209.x.
To compare the incidence of haemorrhagic stroke (HS), and the risk of fatal outcome after HS in patients with oral anticoagulation (OA) treatment and in the general population.
Five-year cohort study.
The Anticoagulation Clinic, Malmö University Hospital, Lund, Sweden.
A total of 4434 patients treated with OA (6693 treatment years) from 1 Oct 1993 to 30 Sept 1998. The population-based Stroke Register of Malmö, Lund, Sweden (STROMA).
Forty-eight patients had HS according to ICD 9 code 430 and 431. HS occurred at a higher age in women compared with men (mean age 79.5 years vs. 74.7 years, P=0.009). The age-adjusted relative risk of HS during OA treatment was 10.9 (CI 6.7-17.6) for men and 9.3 (CI 5.7-15.0) for women, as compared with the untreated general population. Number needed to harm (NNH) (person-years) was 103 for men and 188 for women. Adjusted for age and sex, OA treatment was significantly associated with fatal outcome in patients with HS (OR=2.6, CI 1.4-4.8).
Patients with OA treatment had approximately 10 times higher risk of HS as compared with the general population, and the risk increased markedly with age. OA treatment is associated with an increased case fatality in patients with HS.
比较口服抗凝药（OA）治疗患者与普通人群中出血性卒中（HS）的发生率以及HS后的致命结局风险。
为期五年的队列研究。
瑞典隆德马尔默大学医院抗凝门诊。
1993年10月1日至1998年9月30日期间共4434例接受OA治疗的患者（6693治疗年）。瑞典隆德马尔默基于人群的卒中登记处（STROMA）。
根据国际疾病分类第九版代码430和431，48例患者发生HS。女性发生HS的年龄高于男性（平均年龄79.5岁对74.7岁，P = 0.009）。与未治疗的普通人群相比，OA治疗期间男性HS的年龄调整相对风险为10.9（95%置信区间6.7 - 17.6），女性为9.3（95%置信区间5.7 - 15.0）。危害所需人数（NNH）（人年）男性为103，女性为188。经年龄和性别调整后，OA治疗与HS患者的致命结局显著相关（比值比=2.6，95%置信区间1.4 - 4.8）。
与普通人群相比，接受OA治疗的患者发生HS的风险高出约10倍，且风险随年龄显著增加。OA治疗与HS患者的病死率增加相关。
