22. European Stroke Conference 12 Intracerebral/subarachnoid haemorrhage and venous diseases 12:20 - 12:30 Characteristics associated with antithrombotic drugs prescription after ICH M. Pasquini1, N. Samarasekera2, C.J.J. van Asch3, C.J.M. Klijn4, R. Al-Shahi Salman5, C. Cordonnier6 (1) EA 1046, Univ Lille Nord de France, Department of Neurology, (2) Université Catholique de Lille, Department of Neurology, Lille, FRANCE1,(3) Division of Clinical Neurosciences, School of Clinical Sciences, University of Edinburgh, Edinburgh, UNITED KINGDOM2, (4) Department of Neurology and Neurosurgery, Rudolf Magnus Institute of Neuroscience, University Medical Center, Utrecht, THE NETHERLANDS3, (4) Department of Neurology and Neurosurgery, Rudolf Magnus Institute of Neuroscience, University Medical Center, Utrecht, THE NETHERLANDS4, (3) Division of Clinical Neurosciences, School of Clinical Sciences, University of Edinburgh, Edinburgh, UNITED KINGDOM5, (1) EA 1046, Univ Lille Nord de France, Department of Neurology,Lille, FRANCE6 Background: Almost half of the patients with spontaneous intracerebral haemorrhage (ICH) are on antithrombotic (AT) drugs when they present. Characteristics of survivors and of the sub-group who restart AT drugs are uncertain. Objective: To describe frequencies and characteristics of patients taking AT drugs who survived 1 month after ICH, and identify factors associated with restarting AT drugs. Methods: In 2 hospital-based cohorts (Lille, France, n=542; Utrecht, The Netherlands, n=390) and 1 community-based study (Lothian, Scotland, n=137), we analysed (a) characteristics of 1-month survivors of ICH who had been on AT drugs at the time of ICH and (b) characteristics of survivors associated with restarting AT drugs. Results: 478 patients experienced ICH while on AT drugs. The main reasons for prescribing AT drugs were atrial fibrillation (n=145), previous ischaemic stroke/TIA (IS/TIA; n=154) or isch-aemic heart disease (n=113), but 81 patients (17%) had taken AT drugs for primary prevention. Two-hundred and fifty (52%) patients survived 1 month. Survivors were younger (median age: 75 IQR 65-82 vs 79 IQR 70-84 years; p=0.001) and their ICH locations were more frequent-ly cerebellar (18% vs 8%; p=0.002) and less frequently deep (38% vs 48%; p=0.03). AT drugs were restarted in 61 (31%) of the 199 survivors at discharge who had a pre-ICH indication, but ICH location did not influence this decision (p=0.25). In logistic regression, restarting AT drugs was more likely in patients with a history of hypertension (relative risk RR 3.2, 95% confi-dence interval CI 1.3 to 8.3) and less likely in patients with previous IS/TIA (RR 0.5, 95%CI 0.2 to 0.9). Conclusion: AT drugs were restarted in one third of ICH survivors and appeared to be influ-enced by some patient characteristics. Whether restarting AT drugs is beneficial or not is un-known, and will be addressed in the REstart or STop Antithrombotics Randomised Trial (www. RESTARTtrial.org). 11 Intracerebral/subarachnoid haemorrhage and venous diseases 12:10 - 12:20 Long-term prognosis after primary intracerebral haemorrhage: systematic review and meta-analysis M.T.C. Poon1, A.F. Fonville2, R. Al-Shahi Salman3 Division of Clinical Neurosciences, University of Edinburgh, Edinburgh, UNITED KING-DOM1, Division of Clinical Neurosciences, University of Edinburgh, Edinburgh, UNITED KINGDOM2, Division of Clinical Neurosciences, University of Edinburgh, Edinburgh, UNIT-ED KINGDOM3 Objective: There is uncertainty about the long-term prognosis of spontaneous primary intrace-rebral haemorrhage (ICH) and its predictors. Therefore, we systematically reviewed the litera-ture for studies reporting long-term survival and ICH recurrence, and their predictors. Methods: In February 2012 we searched Ovid Medline from 1902 to 2011 for cohort studies (sample size ≥50) reporting long-term (>30 days) outcome after ICH. Two reviewers extracted data from each study. We meta-analysed 1-year and 5-year survival data from population-based studies using a random effects model (and quantified inconsistency using the I-squared sta-tistic). Results: We identified 123 eligible studies. The pooled estimate of 1-year survival was 46% (95% confidence interval CI 43 to 49%; nine population-based studies n=2408; I-squared 27%) and 5-year survival was 29% (95% CI 26 to 33%; three population-based stud-ies n=699; I-squared 6%). The annual rate of recurrent ICH was 2.0-2.4% among early survi-vors, and data from four hospital-based studies suggested a higher recurrence rate for patients with lobar ICH. In 27 cohort studies the predictors that were most frequently studied, and sig-nificantly associated with death more often than not, were: increasing age, decreasing Glasgow Coma Scale (GCS) score, increasing ICH volume, presence of intraventricular haemorrhage, and deep/infratentorial ICH location. Conclusions: Less than one half of patients with ICH survive one year and less than one third survive 5 years. There are few known predictors of re-current ICH, and studies have not been consistent about the influence of lobar ICH location. A large individual patient data meta-analysis of similar cohort studies would have the statistical power to determine independent predictors of survival and ICH recurrence. 134 © 2013 S. Karger AG, Basel Scientific Programme
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