title: Pharmacotherapy prior to and in acute haemorrhagic stroke. The use of pharmacotherapy and drugs associated outcomes in real-world practice - findings from the Polish Hospital Stroke Registry.
abstract: OBJECTIVE
  Haemorrhagic stroke is associated with substantial mortality and disability, thus prevention and appropriate treatment of acute intracerebral haemorrhage is crucial. We aimed to evaluate the use and the early and late outcomes impact of drugs administered before and in acute haemorrhagic stroke in a real-world practice.
  
  
  METHODS
  Haemorrhagic stroke patients hospitalized between 1st March 2007 and 29th February 2008 and reported in Polish Hospital Stroke Registry were analysed. Fully anonymous data were collected with standardized, authorized access, web-based questionnaire. Multivariate regression models were used to adjust for case-mix and evaluate the impact of drugs used prior to or in acute haemorrhagic stroke on outcomes. The early outcomes were defined as in-hospital mortality or poor outcome (death or dependency - modified Rankin Scale  3) at hospital discharge, while late outcomes covered one-year survival.
  
  
  RESULTS
  A total of 3111 haemorrhagic stroke patients (mean age: 68.9 years; females: 46.7%) was reported. The analysis of pharmacotherapy showed low preventive use of hypotensive agents in hypertensive patients, high consumption of antibiotics and still overuse of vasoactive or neuroprotective compounds in acute haemorrhagic stroke. Regression models confirmed expected negative impact on stroke outcomes associated with oral anticoagulants but not antiplatelets and inconsistent impact of statins used prior to or in acute haemorrhagic stroke.
  
  
  CONCLUSIONS
  Preventive underuse of hypotensive compounds contribute substantially to haemorrhagic stroke risk. The high consumption of antibiotics and neuroprotective or vasoactive compounds in haemorrhagic acute stroke reflect the need to improved quality and evidence-based clinical practice.
authors.affiliation: dr hab. med. Maciej Niewada, Katedra i Zakład Farmakologii Doświadczalnej i Klinicznej, Warszawski Uniwersytet Medyczny, Krakowskie Przedmieście 26/28, 00-927 Warszawa, Polska, e-mail: maciej.niewada@wum.edu.p.
authors.forename: Maciej
authors.initials: M
authors.lastname: Niewada
authors.forename: Marta
authors.initials: M
authors.lastname: Skowrońska
authors.forename: Iwona Marta
authors.initials: IM
authors.lastname: Sarzyńska-Długosz
authors.forename: Bagumił
authors.initials: B
authors.lastname: Kamiński
authors.forename: Adam
authors.initials: A
authors.lastname: Kobayashi
authors.forename: Anna
authors.initials: A
authors.lastname: Członkowska
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D002545:Brain Ischemia / Q000188:drug therapy* / Q000401:mortality / Q000517:prevention & control; D004334:Drug Administration Schedule; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011044:Poland / Q000453:epidemiology; D012042:Registries; D012720:Severity of Illness Index; D020521:Stroke / Q000188:drug therapy* / Q000401:mortality / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors