Is the international normalised ratio a prognostic factor of mortality in intracerebral haemorrhage?

• Published in: Neurologia (Barcelona, Spain) Vol. 26; no. 9; p. 528
• Main Authors: Sousa, L D, Zorrilla, J P, Latini, M F, Alvarez Abut, P, Ayala, M, Romano, L M, Gonorazky, S, Ioli, P, Ricci, L
• Format: Journal Article
• Language: Spanish
• Published: Spain 01.11.2011
• Subjects: Aged; Aged, 80 and over; Anticoagulants - therapeutic use; Cerebral Hemorrhage - diagnosis; Cerebral Hemorrhage - drug therapy; Cerebral Hemorrhage - mortality; Cerebral Hemorrhage - pathology; Female; Hematoma - drug therapy; Hematoma - mortality; Hematoma - pathology; Humans; International Normalized Ratio; Male; Prognosis; Registries; Retrospective Studies
• ISSN: 1578-1968
• DOI: 10.1016/j.nrl.2010.12.018

Oral anticoagulant therapy (ACO) is considered an independent predictor of mortality in patients with intracerebral haemorrhage (ICH), with the role of the international normalised ratio (INR) being unclear. The aim of this work is to evaluate the relationship between ACO and the INR value and the ICH volume, and to determine the relationship between both variables and mortality. Patients were retrospectively analysed using the Private Community Cerebrovascular Hospital Register (Registro Cerebrovascular del Hospital Privado de Comunidad), between December 2003 and May 2009. Volumes of the haematomas (dependent variable) were calculated from the first image performed, using the abc/2 method. Independent variables were age, gender, vascular risk factors, site of bleeding, intraventricular dump, clinical severity (Glasgow scale), time to image, antiplatelet drugs, and INR value on admission. An analysis of the relationship between all these variables and mortality was also performed. A total of 327 patients with HIC were identified (35 with ACO). Median volume was higher in the anticoagulated patients (55ml vs 24ml P<.05), with no statistically significant relationship between volume and the other variables. In the multivariate analysis, a statistically significant higher mortality associated to volume was observed, but not with anticoagulation. Oral anticoagulation was associated with a higher initial volume of the haematoma, with no correlation between the INR value and volume. The HIC volume was directly related to mortality, however, like the volume, the INR was not associated with increased mortality.