Anticoagulation therapy in patients suffering from aneurysmal subarachnoid hemorrhage: influence on functional outcome - a single-center series and multivariate analysis.

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Anticoagulation therapy in patients suffering from aneurysmal subarachnoid hemorrhage: influence on functional outcome - a single-center series and multivariate analysis.

World Neurosurg. 2016 Dec 21;:

Authors: Schuss P, Hadjiathanasiou A, Brandecker S, Güresir Á, Borger V, Wispel C, Vatter H, Güresir E

Abstract
INTRODUCTION: Favourable outcome in patients presenting with aneurysmal subarachnoid hemorrhage (SAH) is determined by several factors. Nevertheless, data on the influence of prior use of oral anticoagulation drugs on functional outcome in patients suffering from SAH is scarce. We therefore analyzed our institutional data.
METHODS: From January 2009 to October 2015, 480 patients suffering from aneurysmal SAH were admitted to our institution. Information, including patient characteristics, treatment modality, aneurysm size and location, radiological features, and functional neurological outcome were assessed and further analyzed. Outcome was assessed according to the modified Rankin Scale (mRS) at 6 months and stratified into favourable (mRS 0-2) versus unfavourable (mRS 3-6).
RESULTS: Overall 17 of 480 patients suffering from aneurysmal SAH were on anticoagulation therapy prior to ictus (4%). Patients without anticoagulation therapy were significantly younger compared to patients with anticoagulation therapy prior to SAH (p=0.005). Furthermore, patients without anticoagulation therapy presented in a significantly better clinical condition compared to patients with anticoagulation therapy prior to SAH (p=0.02). Additionally, patients without anticoagulation therapy achieved significantly more often favourable functional outcome compared to patients with anticoagulation therapy prior to SAH (p=0.02). However, anticoagulation therapy was not identified as significant and independent predictor for unfavourable outcome in the multivariate logistic regression analysis.
CONCLUSION: Anticoagulation therapy has not been identified as significant and independent factor influencing functional outcome in patients suffering from SAH. Therefore, treatment should not be omitted. Nevertheless, cautious management is necessary in patients with known anticoagulation therapy prior to SAH.

PMID: 28011358 [PubMed - as supplied by publisher]

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