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- W2753753230 abstract "To perform a descriptive analysis of intracranial hemorrhages of patients treated with an antivitamin K (fluindione, acenocoumarol or warfarin) or a direct oral anticoagulant (dabigatran, rivaroxaban or apixaban) at the Nancy Regional University Hospital. The study period was from January 2011 to December 2013 and the computerized data (Programme de Médicalisation des Systèmes d’Information) of our hospital was accessed to identify the patients. Clinical data were obtained from the patients’ files. Regional healthcare system was queried for reimbursement data. Among the 157 identified cases of intracranial hemorrhage, 153 were related to antivitamin K, primarily fluindione (n = 127), and only 4 to a direct oral anticoagulant (3 dabigatran and 1 rivaroxaban). During the same period, regional data indicated that 65,345 patients had had at least one reimbursement of antivitamin K and 20,983 patients one reimbursement of an oral direct anticoagulant. In our series, the most frequent intracranial hemorrhages were subdural hematoma (chronic in 65 cases, acute in 50 cases) and intraparenchymal hemorrhage (20 cases). The global mortality rate was 20.2% but varied with the site of hemorrhage. In multivariate analysis, the two risk factors of fatal outcome were coma on admission (OR 6.2; 95%CI: 2.6–15.0) and a history of previous intracranial hemorrhage (OR 13,4; 95% CI: 1,6–114,9). During the 2011–2013 period, antivitamin K, especially fluindione, was the most frequently involved anticoagulants in intracranial hemorrhages with hospitalization at our Regional University Hospital. Coma on admission and a history of previous intracranial hemorrhage were the two main risk factors for fatal outcome. Réaliser une analyse descriptive des cas d’hémorragie intracrânienne avec hospitalisation au CHRU de Nancy concernant des patients traités par antivitamine K (fluindione, warfarine ou acénocoumarol) ou anticoagulant oraux directs (dabigatran, rivaroxaban ou apixaban). Sur la période de janvier 2011 à décembre 2013, identification des patients par une requête dans le Programme de médicalisation des systèmes d’information et recueil clinique à partir des dossiers médicaux. Sur 157 cas d’hémorragie intracrânienne identifiés, 153 étaient observés chez des patients traités par antivitamine K, majoritairement la fluindione (80,9 %) et seulement 4 par anticoagulant oral direct. Sur la même période, dans la région, 65 345 personnes avaient eu au moins un remboursement d’antivitamine K et 20 983 au moins un remboursement d’anticoagulant oral direct. Les hémorragies intracrâniennes les plus fréquentes étaient les hématomes sous-duraux (chroniques : 65 cas, aigus : 50 cas) et les hémorragies intraparenchymateuses (20 cas). Les deux facteurs significativement associés à une évolution fatale en analyse multivariée étaient la présence d’un coma à l’admission (OR 6,2 ; IC95 % 2,6–15,0) et un antécédent d’accident vasculaire cérébral hémorragique (OR 13,4 ; IC95 % 1,6–114,9). Sur la période 2011–2013, la fluindione restait le principal anticoagulant oral impliqué dans les hémorragies intracrâniennes avec hospitalisation au CHRU de Nancy. La présence d’un coma à l’admission et un antécédent d’hémorragie intracrânienne étaient les deux facteurs significativement associés à une évolution fatale." @default.
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- W2753753230 date "2017-09-01" @default.
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- W2753753230 title "Hémorragies intracrâniennes et anticoagulantes orales de patients traités entre 2011 à 2013. Étude descriptive au CHRU de Nancy" @default.
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- W2753753230 doi "https://doi.org/10.1016/j.neuchi.2017.02.002" @default.
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