[Morbi-mortality of medical and surgical treatments in the intracranial bleeding like complication of therapy with drugs that modifies normal coagulation].
BACKGROUND
Antiaggregant and anticoagulant therapy has possible sever secondary effects, being the most serious intracranial bleeding.


OBJECTIVE
Compare morbi-mortality between surgical and medical treatments in anticoagulated and/or antiaggregated patients with any kind of intracranial bleeding. Also risk factors and main indications of those treatments are studied.


METHODS
Descriptive and retrospective study including 105 patients admitted in our Critical Care Unit, with intracranial bleeding, under anticoagulant or antiaggregant treatment. We study the type of bleeding (subarachnoid, epidural, subdural and intraparenchimal bleeding) and the relation between morbi-mortality and treatment applicated using relative risk like analytic tool.


RESULTS
Major bleeding risk appears after the six first months from the beginning of the treatment. Thirty-four patients died with a relative risk of 1.55 in the surgical patients from the medical treatment patients. Relative risk between anticoagulated patients and antiaggregated ones was 1.16. Serious consequences happened on eight of the 49 patients under surgical treatment, and on 13 of the 52 patients under medical treatment.


CONCLUSIONS
Surgical treatment has more morbi-mortality. Oral anticoagulation has only a little more relative risk than treatment with antiaggregants. Both groups had serious consequences.
Virgós-Señor
B
B
Servicio de Medicina Intensiva; Hospital Clínico Universitario Lozano Blesa, Zaragoza, 50009, España. Beaagus@wanadoo.es
Nebra-Puertas
A C
AC
López-Nuñez
C
C
Comuñas-González
F
F
Díaz-Vicente
F J
FJ
Luque-Gómez
P
P
Navarro-Hernando
M A
MA
Santos-Lasaosa
S
S
Tejero-Juste
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects*; D001921:Brain / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006487:Hemostasis / Q000187:drug effects; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D020300:Intracranial Hemorrhages / Q000139:chemically induced / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D014812:Vitamin K / Q000627:therapeutic use*
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D014812:Vitamin K