Suzuki Yuhko, Kitahara Takao, Soma Kazui, Konno Shingo, Sato Kimitoshi, Suzuki Sachio, Oka Hidehiro, Yamada Masaru, Fujii Kiyotaka, Kitahara Yukio, Yamamoto Yuji, Otsuka Takashi, Sugiura Yoshihiro, Kanoh Yuhsaku, Tamai Yoshiko, Ohto Hitoshi
Departments of Blood Transfusion and Transplantation Immunology, Fukushima Medical University, Fukushima, Fukushima, Japan.
Departments of Emergency and Critical Care Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
PLoS One. 2014 May 28;9(5):e97328. doi: 10.1371/journal.pone.0097328. eCollection 2014.
This study examined the impact of platelet transfusion (PLT) on the survival of intracerebral hemorrhage (ICH) patients who had been administered anti-platelet agents (APA). This retrospective cohort analysis investigated 432 patients (259 men, 60%) who were newly diagnosed with ICH between January 2006 and June 2011 at the tertiary emergency center of Kitasato University Hospital. Median age on arrival was 67.0 years (range, 40-95 years). ICH was subcortical in 72 patients (16.7%), supratentorial in 233 (53.9%), and infratentorial in 133 (30.8%). PLT was performed in 16 patients (3.7%). Within 90 days after admission to the center, 178 patients (41.2%) had died due to ICH. Before the onset of ICH, 66 patients had been prescribed APA because of atherosclerotic diseases. Multivariate regression analysis indicated APA administration was an independent risk factor for death within 7 days (odds ratio, 5.12; P = 0.006) and within 90 days (hazard ratio, 1.87; P = 0.006) after arrival. Regarding the effect of a PLT in ICH patients with APA, no patient with PLT died. PLT had a survival benefit on patients with ICH, according to our analysis. Further prospective analysis is necessary to confirm the effects of PLT on survival in ICH with APA.
本研究考察了血小板输注(PLT)对已服用抗血小板药物(APA)的脑出血(ICH)患者生存情况的影响。这项回顾性队列分析调查了2006年1月至2011年6月期间在北里大学医院三级急救中心新诊断为ICH的432例患者(259例男性,占60%)。入院时的中位年龄为67.0岁(范围40 - 95岁)。72例患者(16.7%)的ICH位于皮质下,233例(53.9%)位于幕上,133例(30.8%)位于幕下。16例患者(3.7%)接受了PLT。在进入该中心后的90天内,178例患者(41.2%)因ICH死亡。在ICH发病前,66例患者因动脉粥样硬化疾病而服用了APA。多因素回归分析表明,服用APA是到达后7天内(比值比,5.12;P = 0.006)和90天内(风险比,1.87;P = 0.006)死亡的独立危险因素。关于PLT对服用APA的ICH患者的影响,接受PLT的患者无死亡。根据我们的分析,PLT对ICH患者有生存益处。需要进一步的前瞻性分析来证实PLT对服用APA的ICH患者生存的影响。