Ahead of Print: Reported Antiplatelet Use Influences Long-Term Outcome Independently in Deep Intrace

06/10/2011

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BACKGROUND: Recent studies have focused on antiplatelet [AP] use in ICH patients. Several outcome predictors have been debated, but influences on mortality and outcome still remain controversial, especially for different ICH locations.

OBJECTIVE: To investigate characteristics and functional outcome of ICH patients with reported regular AP use according to hemorrhage locations.

METHODS: This retrospective analysis included 210 consecutive spontaneous ICH patients. Clinical data including the pre-admission-status, initial presentation, neuroradiological data, treatment and outcome were evaluated. Analyses were calculated for AP use versus non-AP use according to hematoma locations, and multivariate models were calculated for hematoma expansion and unfavorable (mRS=4-6) long-term functional outcome (at 1 year).

RESULTS: For all AP users ICH volume was significantly larger, 27.7ml IQR(7.4-66.1) versus 16.8ml IQR(4.2-44.7); (p=0.032). Analyses showed an increased mortality for AP users at 90 days and 1 year (p=0.036; p=0.008). Multivariately, for all ICH patients prior AP use was independently associated with hematoma expansion (OR 3.61; p=0.026) and poorer functional outcome at 1 year (OR 3.82, p=0.035). In deep ICH patients AP use was an independent predictor of an unfavorable functional outcome at 1 year (OR 4.75, p=0.048).

CONCLUSION: Hematoma expansion and more frequent unfavorable long-term functional outcome were independently associated with prior AP use for all patients, and in deep ICH patients AP use was an independent predictor of an unfavorable long-term functional outcome.

Full article access for Neurosurgery subscribers at Neurosurgery-Online.com.