Impact of Platelet Transfusion on Intracerebral Hemorrhage (ICH) in Patients on Antiplatelet Therapy - An Analysis Based on ICH Score.

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Impact of Platelet Transfusion on Intracerebral Hemorrhage (ICH) in Patients on Antiplatelet Therapy - An Analysis Based on ICH Score.

World Neurosurg. 2018 Jan 09;:

Authors: Arnone GD, Kumar P, Wonais MC, Esfahani DR, Campbell-Lee SA, Charbel FT, Amin-Hanjani S, Alaraj A, Seicean A, Mehta AI

Abstract
OBJECTIVE: Platelet transfusions for intracerebral hemorrhage (ICH) patients on antiplatelet therapy (APT) remain controversial. Diverging past research and differences in platelet preparation warrant further investigation of this topic. In this study, the association between platelet transfusion and clinical outcomes of ICH is investigated in patients matched by ICH score, a validated predictor of mortality.
METHODS: A consecutive review of all patients from 2012 to 2015 with non-traumatic ICH was performed. Risk factors including demographics, medical comorbidities, APT use, and ICH score were reviewed. Standardized differences were used to assess baseline characteristics; logistic regression models were performed to determine whether platelet transfusions were associated with adverse outcomes, both before and after matching for ICH score.
RESULTS: 538 non-traumatic ICH patients were investigated. 168 patients were on APT; 71 were excluded. 39 (40%) patients received platelet transfusions and 58 (60%) did not. An overall mortality rate was 9.3% was measured, with 29.9% of patients enduring complications. In the unmatched cohort, patients that received platelet transfusions were more likely to deteriorate (OR 4.7), undergo surgical intervention during their hospital stay (OR 7.2), be discharged with a worse modified Rankin Scale (OR 3.6), and die (OR 6.1). After matching by ICH score, platelet transfusion was not a significant predictor for any negative outcome.
CONCLUSIONS: This is the first analysis of platelet transfusions in ICH patients based on ICH score. For patients on APT, platelet transfusion is not associated with clinical outcomes in an ICH score-matched sample.

PMID: 29330079 [PubMed - as supplied by publisher]

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