title: Anticoagulation Therapy in Patients Suffering from Aneurysmal Subarachnoid Hemorrhage: Influence on Functional Outcome-a Single-Center Series and Multivariate Analysis.
abstract: BACKGROUND
  Favorable outcome in patients presenting with aneurysmal subarachnoid hemorrhage (SAH) is determined by several factors. Nevertheless, data on the influence of prior use of oral anticoagulation drugs on functional outcome in patients suffering from SAH are scarce. We therefore analyzed our institutional data.
  
  
  METHODS
  From January 2009 to October 2015, 480 patients suffering from aneurysmal SAH were admitted to our institution. Information including patient characteristics, treatment modality, aneurysm size and location, radiologic features, and functional neurologic outcome was assessed and further analyzed. Outcome was assessed according to the modified Rankin Scale (mRS) at 6 months and stratified into favorable (mRS 0-2) versus unfavorable (mRS 3-6).
  
  
  RESULTS
  Overall, 17 of 480 patients suffering from aneurysmal SAH were on anticoagulation therapy before ictus (4%). Patients without anticoagulation therapy were significantly younger compared with patients with anticoagulation therapy before SAH (P = 0.005). Furthermore, patients without anticoagulation therapy presented in a significantly better clinical condition compared with patients with anticoagulation therapy before SAH (P = 0.02). Additionally, patients without anticoagulation therapy achieved significantly more often favorable functional outcome compared with patients with anticoagulation therapy before SAH (P = 0.02). However, anticoagulation therapy was not identified as a significant and independent predictor for unfavorable outcome in the multivariate logistic regression analysis.
  
  
  CONCLUSIONS
  Anticoagulation therapy has not been identified as a significant and independent factor influencing functional outcome in patients suffering from SAH. Therefore treatment should not be omitted. Nevertheless, cautious management is necessary in patients with known anticoagulation therapy before SAH.
authors.affiliation: Department of Neurosurgery, Rheinische Friedrich-Wilhelms-University, Bonn, Germany. Electronic address: patrick.schuss@ukb.uni-bonn.de.
authors.forename: Patrick
authors.initials: P
authors.lastname: Schuss
authors.affiliation: Department of Neurosurgery, Rheinische Friedrich-Wilhelms-University, Bonn, Germany.
authors.forename: Alexis
authors.initials: A
authors.lastname: Hadjiathanasiou
authors.affiliation: Department of Neurosurgery, Rheinische Friedrich-Wilhelms-University, Bonn, Germany.
authors.forename: Simon
authors.initials: S
authors.lastname: Brandecker
authors.affiliation: Department of Neurosurgery, Rheinische Friedrich-Wilhelms-University, Bonn, Germany.
authors.forename: Ági
authors.initials: Á
authors.lastname: Güresir
authors.affiliation: Department of Neurosurgery, Rheinische Friedrich-Wilhelms-University, Bonn, Germany.
authors.forename: Valeri
authors.initials: V
authors.lastname: Borger
authors.affiliation: Department of Neurosurgery, Rheinische Friedrich-Wilhelms-University, Bonn, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Wispel
authors.affiliation: Department of Neurosurgery, Rheinische Friedrich-Wilhelms-University, Bonn, Germany.
authors.forename: Hartmut
authors.initials: H
authors.lastname: Vatter
authors.affiliation: Department of Neurosurgery, Rheinische Friedrich-Wilhelms-University, Bonn, Germany.
authors.forename: Erdem
authors.initials: E
authors.lastname: Güresir
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D017542:Aneurysm, Ruptured / Q000150:complications / Q000601:surgery*; D000925:Anticoagulants / Q000627:therapeutic use*; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D019635:Neurosurgical Procedures / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013345:Subarachnoid Hemorrhage / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants
keywords: Anticoagulation; Antithrombotic; Intracranial aneurysm; Subarachnoid hemorrhage