Table 3. Incremental Risk of Concomitant Antiplatelet Therapy by the Type of Anticoagulant Prior to Intracerebral Hemorrhage.
| Outcomes and antiplatelet | Event rate, No./total No. (%) | Adjusted OR (95% CI)a | P value |
|---|---|---|---|
| Factor Xa inhibitors | |||
| In-hospital mortality | |||
| No antiplatelet agent | 1701/6257 (27.2) | 1 [Reference] | NA |
| Single-antiplatelet agent | 729/2740 (26.6) | 1.07 (0.96-1.19) | .22 |
| Dual-antiplatelet agents | 55/198 (27.8) | 1.19 (0.86-1.66) | .30 |
| Death or discharge to hospice | |||
| No antiplatelet agent | 2392/6257 (38.2) | 1 [Reference] | NA |
| Single-antiplatelet agent | 1009/2740 (36.8) | 1.06 (0.96-1.18) | .23 |
| Dual-antiplatelet agents | 74/198 (37.4) | 1.21 (0.89-1.66) | .23 |
| Discharge home | |||
| No antiplatelet agent | 1146/6257 (18.3) | 1 [Reference] | NA |
| Single-antiplatelet agent | 505/2740 (18.4) | 0.95 (0.83-1.09) | .48 |
| Dual-antiplatelet agents | 34/198 (17.2) | 0.69 (0.45-1.05) | .08 |
| Independent ambulation at discharge | |||
| No antiplatelet agent | 1198/4249 (28.2) | 1 [Reference] | NA |
| Single-antiplatelet agent | 506/1868 (27.1) | 0.89 (0.77-1.03) | .11 |
| Dual-antiplatelet agents | 41/137 (29.9) | 0.92 (0.63-1.35) | .67 |
| Modified Rankin Scale score 0-1 | |||
| No antiplatelet agent | 318/4553 (7.0) | 1 [Reference] | NA |
| Single-antiplatelet agent | 137/1986 (6.9) | 0.85 (0.67-1.08) | .19 |
| Dual-antiplatelet agents | 11/144 (7.6) | 0.88 (0.48-1.63) | .69 |
| Modified Rankin Scale score 0-2 | |||
| No antiplatelet agent | 500/4553 (11.0) | 1 [Reference] | NA |
| Single-antiplatelet agent | 208/1986 (10.5) | 0.82 (0.66-1.01) | .06 |
| Dual-antiplatelet agents | 16/144 (11.1) | 0.79 (0.47-1.32) | .37 |
| Warfarin | |||
| In-hospital mortality | |||
| No antiplatelet agent | 4472/13 966 (32.0) | 1 [Reference] | NA |
| Single-antiplatelet agent | 2306/6921 (33.3) | 1.16 (1.09-1.24) | <.001 |
| Dual-antiplatelet agents | 246/524 (46.9) | 2.07 (1.72-2.50) | <.001 |
| Death or discharge to hospice | |||
| No antiplatelet agent | 5916/13 966 (42.4) | 1 [Reference] | NA |
| Single-antiplatelet agent | 2944/6921 (42.5) | 1.13 (1.06-1.21) | <.001 |
| Dual-antiplatelet agents | 280/524 (53.4) | 1.86 (1.54-2.26) | <.001 |
| Discharge home | |||
| No antiplatelet agent | 2285/13 966 (16.4) | 1 [Reference] | NA |
| Single-antiplatelet agent | 1134/6921 (16.4) | 0.96 (0.88-1.05) | .39 |
| Dual-antiplatelet agents | 72/524 (13.7) | 0.71 (0.55-0.94) | .01 |
| Independent ambulation at discharge | |||
| No antiplatelet agent | 2391/8727 (27.4) | 1 [Reference] | NA |
| Single-antiplatelet agent | 1195/4264 (28.0) | 1.00 (0.92-1.10) | .91 |
| Dual-antiplatelet agents | 76/255 (29.8) | 1.04 (0.78-1.38) | .81 |
| Modified Rankin Scale score 0-1 | |||
| No antiplatelet agent | 599/10 220 (5.9) | 1 [Reference] | NA |
| Single-antiplatelet agent | 283/5071 (5.6) | 0.81 (0.69-0.96) | .02 |
| Dual-antiplatelet agents | 23/412 (5.6) | 0.73 (0.45-1.19) | .21 |
| Modified Rankin Scale score 0-2 | |||
| No antiplatelet agent | 927/10 220 (9.1) | 1 [Reference] | NA |
| Single-antiplatelet agent | 459/5071 (9.1) | 0.87 (0.75-1.00) | .05 |
| Dual-antiplatelet agents | 33/412 (8.0) | 0.66 (0.43-1.01) | .05 |
| No OAC | |||
| In-hospital mortality | |||
| No antiplatelet agent | 28749/128 754 (22.3) | 1 [Reference] | NA |
| Single-antiplatelet agent | 11400/51 874 (22.0) | 1.01 (0.98-1.05) | .42 |
| Dual-antiplatelet agents | 2466/8244 (29.9) | 1.56 (1.47-1.65) | <.001 |
| Death or discharge to hospice | |||
| No antiplatelet agent | 38096/128 754 (29.6) | 1 [Reference] | NA |
| Single-antiplatelet agent | 16637/51 874 (32.1) | 1.00 (0.97-1.03) | .95 |
| Dual-antiplatelet agents | 3228/8244 (39.2) | 1.38 (1.30-1.46) | <.001 |
| Discharge home | |||
| No antiplatelet agent | 35360/128 754 (27.5) | 1 [Reference] | NA |
| Single-antiplatelet agent | 11823/51 874 (22.8) | 1.04 (1.01-1.07) | .008 |
| Dual-antiplatelet agents | 1657/8244 (20.1) | 0.91 (0.85-0.97) | .004 |
| Independent ambulation at discharge | |||
| No antiplatelet agent | 31591/86 122 (36.7) | 1 [Reference] | NA |
| Single-antiplatelet agent | 11782/37 441 (31.5) | 1.04 (1.01-1.07) | .02 |
| Dual-antiplatelet agents | 1606/5333 (30.1) | 1.03 (0.96-1.10) | .40 |
| Modified Rankin Scale score 0-1 | |||
| No antiplatelet agent | 9445/84 302 (11.2) | 1 [Reference] | NA |
| Single-antiplatelet agent | 3163/35801 (8.8) | 1.04 (0.98-1.10) | .17 |
| Dual-antiplatelet agents | 425/6013 (7.1) | 0.86 (0.76-0.97) | .02 |
| Modified Rankin Scale score 0-2 | |||
| No antiplatelet agent | 13734/84 302 (16.3) | 1 [Reference] | NA |
| Single-antiplatelet agent | 4929/35 801 (13.8) | 1.07 (1.02-1.13) | .006 |
| Dual-antiplatelet agents | 665/6013 (11.1) | 0.87 (0.78-0.97) | .01 |
Abbreviations: NA, not applicable; OAC, oral anticoagulant; OR, odds ratio.
a
Adjustment for age, sex, race/ethnicity, insurance, medical history (atrial fibrillation or flutter, coronary artery disease or prior myocardial infarction, prior stroke, prior transient ischemic attack, carotid stenosis, heart failure, hypertension, peripheral vascular disease, diabetes, dyslipidemia, obesity, renal insufficiency, smoking status, and drug or alcohol abuse), transport by emergency medical services, transfer in, arrived during off-hours, antihypertensive, lipid-lowering medication prior to admission, rural hospital, hospital number of beds, academic center, geographic regions, primary stroke center, and comprehensive stroke center.