Warfarin, hematoma expansion, and outcome of intracerebral hemorrhage
Warfarin, hematoma expansion, and outcome of intracerebral hemorrhage
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DOI：
10.1212/01.wnl.0000138428.40673.83
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发表时间：
2004-09-28
期刊：
影响因子：
9.9
通讯作者：
Rosand, J
中科院分区：
文献类型：
--
作者：
Flibotte, JJ;Hagan, N;Rosand, J
背景：脑出血（ICH）的死亡率增加。作者研究了该效应是否反映了就诊时基线ICH体积增加或ICH扩张增加。方法：受试者来自一项正在进行的ICH结局前瞻性队列研究。在急诊科连续5年收治的183例年龄大于或等于18岁的幕上脑出血患者中研究华法林对基线脑出血体积的影响。使用计算机容量分析确定基线ICH体积。在70例连续病例中分析华法林对ICH扩大（体积增加大于或等于基线的33%）的影响，这些病例在入院后7天内通过所有后续CT扫描测量ICH体积。多变量分析用于确定华法林对基线ICH、ICH扩展的影响，以及华法林对ICH死亡率的影响是否取决于基线体积或随后的扩展。结果：华法林对初始容量无影响。高血糖是基线容量增大的预测因素（p
Background: Warfarin increases mortality of intracerebral hemorrhage (ICH). The authors investigated whether this effect reflects increased baseline ICH volume at presentation or increased ICH expansion. Methods: Subjects were drawn from an ongoing prospective cohort study of ICH outcome. The effect of warfarin on baseline ICH volume was studied in 183 consecutive cases of supratentorial ICH age greater than or equal to18 years admitted to the emergency department over a 5-year period. Baseline ICH volume was determined using computerized volumetric analysis. The effect of warfarin on ICH expansion (increase in volume greater than or equal to33% of baseline) was analyzed in 70 consecutive cases in whom ICH volumes were measured on all subsequent CT scans up to 7 days after admission. Multivariable analysis was used to determine warfarin's influence on baseline ICH, ICH expansion, and whether warfarin's effect on ICH mortality was dependent on baseline volume or subsequent expansion. Results: There was no effect of warfarin on initial volume. Predictors of larger baseline volume were hyperglycemia (p