title: Prognostic factors and analysis of mortality due to brain haemorrhages associated with vitamin K antagonist oral anticoagulants. Results from the TAC registry.
abstract: BACKGROUND
  Intracranial haemorrhages (ICH) represent a severe and frequently lethal complication in patients treated with vitamin K antagonists (VKA). The purpose of our study is to describe the factors and clinical features associated with mortality in these patients.
  
  
  METHODS
  We conducted an observational, retrospective, multi-centre study based on prospective stroke registries in Spain. We included all patients admitted to neurology departments during a one-year period who met the following inclusion criteria: being 18 or older, having a diagnosis of ICH, and receiving VKA. Clinical and radiological parameters and 3-month outcomes were analysed.
  
  
  RESULTS
  A total of 235 patients from 21 hospitals were included. Mortality rate at 90 days was 42.6%. Bivariate analysis showed a significant association between death and the following factors: median NIHSS score at admission (5 [IQR = 9] vs 17 [IQR = 14] points, P<.01) and presence of an extensive hemispheric haemorrhage (4.9% vs 35%, P < .01; χ2). Extensive hemispheric haemorrhages, in addition to being the most lethal type, were associated with a shorter time to death (mean of 16.5 days; 95% CI: 7.1-26). A logistic regression model showed that only baseline NIHSS scores independently predicted death (odds ratio=1.13 [95% CI: 1.08-1.17] for each point in the scale).
  
  
  CONCLUSIONS
  ICH in patients treated with VKA is associated with high mortality rates; mortality in these patients is mainly and independently associated with the clinical situation at stroke onset.
authors.affiliation: Servicio de Neurología, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria La Princesa, Madrid, España. Electronic address: gzapatawainberg@gmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Zapata-Wainberg
authors.affiliation: Servicio de Neurología, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria La Princesa, Madrid, España.
authors.forename: S
authors.initials: S
authors.lastname: Quintas
authors.affiliation: Servicio de Neurología, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria La Princesa, Madrid, España.
authors.forename: A
authors.initials: A
authors.lastname: Ximénez-Carrillo Rico
authors.affiliation: Servicio de Neurología, Hospital Universitario Central de Asturias, Oviedo, España.
authors.forename: L
authors.initials: L
authors.lastname: Benavente Fernández
authors.affiliation: Servicio de Neurología, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá.
authors.forename: J
authors.initials: J
authors.lastname: Masjuan Vallejo
authors.affiliation: Servicio de Neurología, Complejo Hospitalario de Navarra, Pamplona, Navarra, España.
authors.forename: J
authors.initials: J
authors.lastname: Gállego Culleré
authors.affiliation: Servicio de Neurología, Hospital Universitario Basurto Bilbao, Vizcaya, España.
authors.forename: M Del M
authors.initials: MDM
authors.lastname: Freijó Guerrero
authors.affiliation: Servicio de Neurología, Hospital Universitario Clínico San Carlos, Madrid, España.
authors.forename: J
authors.initials: J
authors.lastname: Egido
authors.affiliation: Servicio de Neurología, Hospital Universitario de Salamanca, Salamanca, España.
authors.forename: J C
authors.initials: JC
authors.lastname: Gómez Sánchez
authors.affiliation: Servicio de Neurología, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
authors.forename: A
authors.initials: A
authors.lastname: Martínez Domeño
authors.affiliation: Servicio de Neurología, Hospital Universitari Arnau de Vilanova, Lleida, España.
authors.forename: F
authors.initials: F
authors.lastname: Purroy
authors.affiliation: Servicio de Neurología, Hospital Universitari Son Espases, Mallorca, Islas Baleares, España.
authors.forename: B
authors.initials: B
authors.lastname: Vives Pastor
authors.affiliation: Servicio de Neurología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, España.
authors.forename: M
authors.initials: M
authors.lastname: Rodríguez Yáñez
authors.affiliation: Servicio de Neurología, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria La Princesa, Madrid, España.
authors.forename: J
authors.initials: J
authors.lastname: Vivancos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D002423:Cause of Death; D002543:Cerebral Hemorrhage / Q000139:chemically induced* / Q000401:mortality*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D020521:Stroke / Q000150:complications; D014812:Vitamin K / Q000037:antagonists & inhibitors*; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D014812:Vitamin K
keywords: Acenocoumarol; Acenocumarol; Anticoagulantes orales; Hemorragia cerebral; Intracranial haemorrhage; Mortalidad; Mortality; Oral anticoagulants; Warfarin; Warfarina