Preadmission use of warfarin improves short-term outcome in patients with acute cerebral infarction. The Bergen Stroke Study.
BACKGROUND
We hypothesized that patients with cerebral infarction on preadmission warfarin have less severe neurological deficits on admittance, less severe neurological deficits 1 week after the onset of cerebral infarction and a larger improvement as to neurological deficits within 1 week of acute cerebral infarction.


METHODS
All patients with cerebral infarction who did not receive thrombolytic treatment were included. Preadmission use of warfarin was registered. The National Institute of Health Stroke Scale (NIHSS) score was obtained on admittance and 7 days after stroke onset.


RESULTS
In total, 42 patients (8.1%) used warfarin at the time of stroke onset. The mean NIHSS score on admittance was 6.9 among the patients on warfarin and 5.2 among those without warfarin (p = 0.10). The 1-week improvement in the NIHSS score was 3.5 among the patients on warfarin and 0.8 among the participants without warfarin (p < 0.001). Linear regression showed that a low NIHSS score on day 7 was independently associated with a low NIHSS score on admittance (p < 0.001), low age (p = 0.002) and preadmission use of warfarin (p < 0.001).


CONCLUSIONS
Preadmission warfarin was not associated with less severe neurological deficits on admittance. However, it was related to both less severe neurological deficits 1 week after the onset of cerebral infarction and larger improvement as to neurological deficits within 1 week of acute cerebral infarction.
Department of Neurology, Haukeland University Hospital, University of Bergen, Bergen, Norway. halvor.naess@haukeland.no
Halvor
H
Naess
Jan
J
Brogger
Ulrike
U
Waje-Andreassen
Titto T
TT
Idicula
Lars
L
Thomassen
D000208:Acute Disease; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy; D002544:Cerebral Infarction / Q000150:complications* / Q000175:diagnosis / Q000517:prevention & control*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D009422:Nervous System Diseases / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D009664:Norway; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D013997:Time Factors; D014859:Warfarin / Q000627:therapeutic use*
D000925:Anticoagulants; D014859:Warfarin