Department of Neurology, Charité-Universitätsmedizin Berlin, Hindenburgdamm 30, 12200, Berlin, Germany.
Center for Stroke Research Berlin (CSB), Berlin, Germany.
Neurol Sci. 2018 Apr;39(4):745-748. doi: 10.1007/s10072-018-3255-z. Epub 2018 Feb 14.
Hematoma volume (HV) and hematoma growth (HG) predict mortality and poor outcome in intracerebral hemorrhage (ICH). While the influence of oral anticoagulation on HV, HG and outcome is well established, the effect of prior antiplatelet therapy (APT) remains uncertain. We retrospectively examined data from all patients with acute, primary ICH, and baseline head CT admitted to our department between January 2005 and February 2014. HV were calculated by ABC/2 method. HG was defined as present if HV increased between baseline and follow-up CT ≥ 30% or ≥ 6 mL. We analyzed the influence of APT on HV, HG, and in-hospital mortality using univariate and multivariate analyses. In addition, we used propensity score matching to assess differences in in-hospital mortality rates. From 668 screened patients, 343 had primary ICH and fulfilled all inclusion criteria. APT was present in 99 patients (29%). Baseline median HV was 16 mL (IQR 6-46). HG occurred in 44 of 160 patients with follow-up CT (28%). In-hospital mortality was 10% (n = 36). APT was associated with older age, a mRS score before admission (pre-mRS) of > 2, and presence of cardiovascular comorbidities. We did not find an association between APT and larger baseline HV (p = 0.32), or HG (OR 0.8, 95% CI 0.4-1.9). After propensity score matching for age, pre-mRS, gender, and cardiovascular comorbidities, APT was not associated with higher in-hospital mortality (OR 1.90, 95% CI 0.85-4.24, p = 0.117). This study did not show a higher risk for larger HV, HG, or in-hospital mortality in primary ICH patients with APT.
血肿体积（HV）和血肿增长（HG）可预测脑出血（ICH）患者的死亡率和不良预后。虽然口服抗凝剂对 HV、HG 和预后的影响已得到充分证实，但抗血小板治疗（APT）的效果仍不确定。我们回顾性分析了 2005 年 1 月至 2014 年 2 月期间我院所有因急性、原发性 ICH 且基线头部 CT 入院的患者的数据。采用 ABC/2 法计算 HV。如果 HV 基线和随访 CT 之间增加≥30%或≥6 mL，则定义为 HG 存在。我们使用单变量和多变量分析来分析 APT 对 HV、HG 和住院死亡率的影响。此外，我们还使用倾向评分匹配来评估住院死亡率的差异。从 668 例筛选出的患者中，有 343 例为原发性 ICH 且符合所有纳入标准。有 99 例（29%）患者存在 APT。基线 HV 中位数为 16 mL（IQR 6-46）。有 160 例患者进行了随访 CT，其中 44 例（28%）出现 HG。住院死亡率为 10%（n=36）。APT 与年龄较大、入院前 mRS 评分（pre-mRS）>2 及存在心血管合并症有关。我们未发现 APT 与较大的基线 HV（p=0.32）或 HG 之间存在关联（OR 0.8，95%CI 0.4-1.9）。在校正年龄、pre-mRS、性别和心血管合并症的倾向评分后，APT 与较高的住院死亡率无关（OR 1.90，95%CI 0.85-4.24，p=0.117）。本研究未显示 APT 与原发性 ICH 患者较大的 HV、HG 或住院死亡率之间存在更高的风险。
