Table 1.
Parameter | Value | References | ||||||
---|---|---|---|---|---|---|---|---|
Gene frequency of CYP2C9*2 and/or CYP2C9*3 | 0.20 | 4,11,54–56 | ||||||
Relative hazard of major bleed in variants versus “wild-type” CYP2C9 variants | ||||||||
Initiation phase | 3.94 | 11,15 | ||||||
Maintenance phase | 2.39 | 11,15 | ||||||
Relative hazard of major bleed during initiation phase versus maintenance phase - | ||||||||
General population | 1.9 | 26 | ||||||
CYP2C9 variants | 4.7 | Calculated | ||||||
CYP2C9 “wild-type” | 1.2 | Calculated | ||||||
Rate of thromboembolism - untreated (%/year) | 0.045 | 35,57 | ||||||
Efficacy of treatment | ||||||||
With warfarin | 0.68 | 35 | ||||||
With aspirin | 0.22 | 23,57 | ||||||
Rate of thromboembolism - treated with warfarin (%/year) | 0.014 | Calculated | ||||||
Rate of thromboembolism - treated with aspirin (%/year) | 0.04 | Calculated | ||||||
Probable outcome from thromboembolic event | ||||||||
Death | 0.27 | 35 | ||||||
Permanent sequelae | 0.44 | 35,58 | ||||||
With severe disability | 0.29 | 35,59,60 | ||||||
With mild disability | 0.71 | 35,59,60 | ||||||
Good recovery | 0.29 | 35,58 | ||||||
Location of hemorrhage (value) (reference) | ||||||||
Lobar ICH | Deep ICH | Extra-cranial | Subdural hematoma | |||||
Rate of bleeding —untreated (%/year) | 0.00035 | 46 | 0.00035 | 46 | 0.006 | 22 | 0.00025 | 29,35 |
Probable outcome from bleeding event - without warfarin* | ||||||||
Death | 0.190 | 41 | 0.207 | 41 | 0.13 | 0.20 | 61 | |
Severe long-term disability — GOS=3† | 0.428 | 41 | 0.436 | 41 | 0.07‡ | |||
Mild long-term disability — GOS=4† | 0.196 | 41 | 0.187 | 41 | 0.40‡ | |||
Good recovery - GOS=5† | 0.185 | 41 | 0.170 | 41 | 0.17‡ | |||
Relative hazard of bleeding on anticoagulants | 5.7 | 62 | 5.7 | 62 | 2.4 | 63 | 4.0 | 29,32 |
Rate of bleeding on anticoagulants (%/year) | 0.002 | 46 | 0.002 | 46 | 0.014 | 0.001 | 35 | |
Probable outcome from bleeding event - on warfarin | ||||||||
Death | 0.379 | 0.405 | 0.15 | 63 | 0.20 | 61 | ||
Severe long-term disability - GOS=3† | 0.429 | 0.420 | 0.09 | 61 | ||||
Mild long-term disability — GOS=4† | 0.111 | 0.103 | 0.50 | 61 | ||||
Good recovery - GOS=5† | 0.080 | 0.073 | 0.20 | 61 | ||||
Variable | Quality of life | |||||||
Value | Reference | |||||||
Long-term morbidities | ||||||||
Well | 1.0 | |||||||
Well while receiving anticoagulants | 0.99 | 64 | ||||||
Severe long-term disability | 0.11 | 64 | ||||||
Mild long-term disability | 0.76 | 64 | ||||||
Dead | 0.0 | |||||||
Short-term morbidities in patients with resolution | ||||||||
Extracranial bleeding event§ | 0.84 | |||||||
Intracerebral hemorrhage║ | 0.79 | |||||||
Thromboembolic event║ | 0.79 |
*Assume outcomes of bleeding events for aspirin-treated patients are the same as for untreated patients
†GOS — Glascow Outcomes Score at 3 months
‡ Assume same distribution of neurological outcomes in survivors as in anticoagulated patients with subdural hematoma
§Assume Q = 0 for duration of hospitalization; length of stay (LOS) for gastrointestinal hemorrhage (DRG 174) =4.9 days
‖LOS for specific cerebrovascular disorders except transient ischemic attack (DRG 14) =6.4 days