抗凝固療法中および抗血小板療法中に発症した脳内出血の検討  [in Japanese] Effect of Anticoagulant or Antiplatelet Therapy on Outcome after Intracerebral Hemorrhage  [in Japanese]

We investigated whether pretreatment of anticoagulant agents and antiplatelet agents affect the prognosis in patients with intracerebral hemorrhage (ICH). We retrospectively reviewed the medical records of 451 patients admitted to our center due to intracerebral hemorrhage within 24 hours after onset during an 8-year period from 1998 to 2005. The ICH patients were divided into 4 groups: patients with anticoagulant therapy (AC, 20 patients), with antiplatelet therapy (AP, 47 patients), with combined anticoagulant and antiplatelet therapy (AC + AP, 8 patients), and with no pretreatment (NT, 376 patients). We also selected 345 patients with ICH who had undergone a second CT within 24 hours of initial scan and evaluated the hematoma volume in each scan and the ratio of hematoma enlargement. The AC + AP group showed a worse prognosis and higher in-hospital mortality than the NT group. Meanwhile, the AC and AP group showed no tendency of higher mortality or poor prognosis. Pretreatment of combination of warfarin and aspirin is associated with poor prognosis and higher mortality in patients with ICH.