[Morbi-mortality of medical and surgical treatments in the intracranial bleeding like complication of therapy with drugs that modifies normal coagulation]

Rev Neurol. 2001 May;32(9):829-32.
[Article in Spanish]

Abstract

Introduction: Antiaggregant and anticoagulant therapy has possible sever secondary effects, being the most serious intracranial bleeding.

Objectives: 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.

Patients and 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.

Publication types

  • English Abstract

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anticoagulants / administration & dosage*
  • Anticoagulants / adverse effects*
  • Brain / surgery*
  • Combined Modality Therapy
  • Female
  • Hemostasis / drug effects
  • Humans
  • Hyperlipidemias / epidemiology
  • Intracranial Hemorrhages* / chemically induced
  • Intracranial Hemorrhages* / mortality
  • Intracranial Hemorrhages* / therapy
  • Male
  • Middle Aged
  • Platelet Aggregation Inhibitors / administration & dosage*
  • Platelet Aggregation Inhibitors / adverse effects*
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Smoking / epidemiology
  • Vitamin K / therapeutic use*

Substances

  • Anticoagulants
  • Platelet Aggregation Inhibitors
  • Vitamin K