Table 1.
Clinical characteristics of patients with oral anticoagulation-ICH and mechanical heart valve who received sufficient oral anticoagulation reversal or insufficient oral anticoagulation reversal (n = 148)
| Sufficient INR reversal (n = 37) | Insufficient INR reversal (n = 111) | P-value | |
|---|---|---|---|
| Age (years), mean (±SD) | 69 (59–75) | 70 (62–76) | 0.44 |
| Female sex, n (%) | 11 (29.7) | 42 (37.8) | 0.37 |
| Pre-mRS, mean (±SD)a | 0 (0–1) | 0 (0–2) | 0.38 |
| Symptom onset–onset admission, (min), median (IQR) | 125 (70–202) | 129 (60–348) | 0.73 |
| Glasgow coma scale, median (IQR)b | 9 (3–14) | 14 (10–15) | <0.01 |
| Mechanical heart valve positions, n (%) | |||
| Aortic valve | 27 (73.0) | 69 (62.2) | 0.23 |
| Mitral valve | 10 (27.0) | 32 (28.8) | 0.84 |
| Both locations | 0 (0.0) | 10 (9.0) | 0.12 |
| Imaging | |||
| Deep ICH, n (%) | 15 (40.5) | 45 (40.5) | 1.00 |
| Lobar ICH, n (%) | 18 (48.6) | 51 (45.9) | 0.78 |
| Other ICH locations, n (%) | 4 (5.4) | 15 (9.0) | 0.78 |
| ICH volume (mL), median (IQR) | 28.1 (14.8–63.0) | 19.4 (7.8–43.0) | 0.05c |
| Intraventricular haemorrhage, n (%) | 23 (62.2) | 40 (36.0) | <0.01 |
| Reversal treatment | |||
| Admission reversal (min), median (IQR) | 80 (54–120) | 101 (60–235) | 0.15 |
| Any reversal treatment, n (%) | 37 (100.0) | 109 (98.2) | 1.00 |
| PCC, n (%) | 37 (100.0) | 99 (89.2) | 0.07 |
| Dose (IU), median (IQR) | 2500 (1800–3200) | 2000 (1500–3000) | 0.15 |
| FFP, n (%) | 7 (18.9) | 16 (14.4) | 0.51 |
| Konakion, n (%) | 31 (83.8) | 84 (75.7) | 0.31 |
| Blood pressure control (mmHg), median (IQR) | |||
| Initial systolic BP | 162 (133–187) | 156 (140–186) | 0.85 |
| Initial diastolic BP | 89 (72–98) | 80 (70–99) | 0.89 |
| Initial mean arterial BP | 108 (89–127) | 107 (96–127) | 0.77 |
| Systolic BP (4 h) | 141 (120–159) | 141 (122–152) | 0.99 |
| Diastolic BP (4 h) | 65 (60–74) | 70 (60–80) | 0.31 |
| Mean arterial BP (4 h) | 93 (79–101) | 91 (83–103) | 0.65 |
| Systolic BP (8 h) | 133 (125–141) | 132 (117–142) | 0.41 |
| Diastolic BP (8 h) | 68 (60–73) | 65 (58–74) | 0.63 |
| Mean arterial BP (8 h) | 89 (83–98) | 87 (80–96) | 0.36 |
| Systolic BP (12 h) | 127 (110–149) | 135 (123–145) | 0.22 |
| Diastolic BP (12 h) | 60 (56–73) | 66 (57–75) | 0.43 |
| Mean arterial BP (12 h) | 83 (75–100) | 89 (80–96) | 0.33 |
| Coagulation parameters | |||
| INR on admission, median (IQR) | 2.83 (2.4.6–3.67) | 2.70 (2.40–3.44) | 0.27 |
| 1st INR after reversal, median (IQR) | 1.17 (1.11–1.22) | 1.39 (1.27–1.60) | <0.01 |
| INR <1.3 on 1st INR after reversal, n (%) | 37 (100.0) | 34 (30.6) | <0.01 |
| INR <1.3 within 4 h, n (%) | 37 (100.0) | 0 (0.0) | <0.01 |
| INR after 24 h, median (IQR) | 1.26 (1.20–1.37) | 1.27 (1.20–1.39) | 0.64 |
| INR after 48 h, median (IQR) | 1.24 (1.13–1.34) | 1.26 (1.16–1.41) | 0.41 |
| INR after 72 h, median (IQR) | 1.23 (1.11–1.37) | 1.25 (1.14–1.46) | 0.33 |
| Complications ≤72 h after ICH, n (%) | |||
| Haemorrhagic complications | |||
| Hematoma enlargement | 6/30 (20) | 49/100 (49) | <0.01 |
| Other intracranial haemorrhage | 1 (2.7) | 0 (0.0) | 0.25 |
| Extracranial haemorrhage | 0 (0.0) | 0 (0.0) | 1.00 |
| Thromboembolic complication | 0 (0.0) | 0 (0.0) | 1.00 |
| Complications ≥72 h after ICH, n (%) | |||
| Haemorrhagic complications | 5 (13.5) | 16 (14.4) | 0.89 |
| Thromboembolic complication | 2 (5.4) | 6 (5.4) | 1.00 |
| Anticoagulation management | |||
| Therapeutic Anticoagulation, n (%) | 16 (43.2) | 53 (47.7) | 0.63 |
| Day after ICH, median (IQR) | 7 (1–17) | 4 (1–11) | 0.89 |
| <72 h after ICH, n (%) | 7 (18.9) | 20 (18.0) | 0.88 |
Significant parameters are presented in bold. Sufficient OAC reversal was defined as achieving INR values <1.3 within 4 h after admission.
ICH, intracerebral haemorrhage; INR, international normalized ratio; IQR, interquartile range; IU, international unit; mRS, modified Rankin Scale; SD, standard deviation.
a
Modified Rankin Scale range 0–6, from no disability to death.
b
Glasgow coma scale range 3–15, from deep coma to alert.
c
Not significant after Holm’s sequential Bonferroni correction.