Koon-Ho Chan1, Gilberto Ka-Kit Leung2, Kui-Kai Lau1, Shasha Liu3, Wai-Man Lui2, Chu Pak Lau3, Hung-Fat Tse3, Jenny Kan-Suen Pu4, Chung-Wah Siu5. 1. Neurology Division, Department of Medicine, the University of Hong Kong, Hong Kong SAR, People's Republic of China. 2. Division of Neurosurgery, Department of Surgery, the University of Hong Kong, Hong Kong SAR, People's Republic of China. 3. Cardiology Division, Department of Medicine, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, People's Republic of China. 4. Division of Neurosurgery, Department of Surgery, the University of Hong Kong, Hong Kong SAR, People's Republic of China. Electronic address: ksjpu@hkucc.hku.hk. 5. Cardiology Division, Department of Medicine, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, People's Republic of China. Electronic address: cwdsiu@hkucc.hku.hk.
Abstract
BACKGROUND: Patients who survive intracranial hemorrhage (ICH) are at high risk of recurrence. The Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly (Age >65 years), Drugs/Alcohol Concomitantly (HAS-BLED) score has recently been developed to assess bleeding risk. METHODS: This observational study was aimed to investigate the prognostic performance of the HAS-BLED score in predicting recurrent ICH. Consecutive patients (434) with a first spontaneous ICH who were not prescribed antiplatelet or anticoagulation therapy (59.8 ± 15.3 years; men, 62.3%) were recruited. RESULTS: Most patients (71.6%) had a HAS-BLED score of >1. After a follow-up of 52.7 months, there were 42 ICH recurrences (2.25 per 100 patient-years). The risk of ICH recurrence increased with HAS-BLED score. Specifically, the risk of ICH recurrence with HAS-BLED score of 1, 2, 3, and 4 were 1.37, 2.38, 3.39, and 2.90 per 100 patient-years, respectively. The sensitivity and specificity of HAS-BLED was 79.1% and 29.2%, respectively, with C-statistic of 0.54 (0.50-0.59). CONCLUSION: This study provided data on the risk of ICH recurrence stratified using the HAS-BLED score in patients after an ICH.
BACKGROUND:Patients who survive intracranial hemorrhage (ICH) are at high risk of recurrence. The Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly (Age >65 years), Drugs/Alcohol Concomitantly (HAS-BLED) score has recently been developed to assess bleeding risk. METHODS: This observational study was aimed to investigate the prognostic performance of the HAS-BLED score in predicting recurrent ICH. Consecutive patients (434) with a first spontaneous ICH who were not prescribed antiplatelet or anticoagulation therapy (59.8 ± 15.3 years; men, 62.3%) were recruited. RESULTS: Most patients (71.6%) had a HAS-BLED score of >1. After a follow-up of 52.7 months, there were 42 ICH recurrences (2.25 per 100 patient-years). The risk of ICH recurrence increased with HAS-BLED score. Specifically, the risk of ICH recurrence with HAS-BLED score of 1, 2, 3, and 4 were 1.37, 2.38, 3.39, and 2.90 per 100 patient-years, respectively. The sensitivity and specificity of HAS-BLED was 79.1% and 29.2%, respectively, with C-statistic of 0.54 (0.50-0.59). CONCLUSION: This study provided data on the risk of ICH recurrence stratified using the HAS-BLED score in patients after an ICH.
Authors: Wen-Hua Li; Duo Huang; Chern-En Chiang; Chu-Pak Lau; Hung-Fat Tse; Esther W Chan; Ian C K Wong; Gregory Y H Lip; Pak-Hei Chan; Chung-Wah Siu Journal: Clin Cardiol Date: 2016-11-28 Impact factor: 2.882
Authors: Ching-Jen Chen; Dale Ding; Thomas J Buell; Fernando D Testai; Sebastian Koch; Daniel Woo; Bradford B Worrall Journal: Neurology Date: 2018-05-30 Impact factor: 9.910