Xiaowen Song1, Qian Zhang1, Yong Cao1, Shuo Wang1, Jizong Zhao2. 1. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Research Center for Neurological Disease, Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100070, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, 100070, China. 2. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Research Center for Neurological Disease, Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100070, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, 100070, China. Electronic address: zhaojz205@163.com.
Abstract
OBJECTIVES: This study aimed to find the effect of antiplatelet therapy on hematoma volume, rehaemorrhage rate and prognosis of intracerebral hemorrhage patients after surgery. PATIENTS AND METHODS: 101 surgically treated intracerebral hemorrhage subjects were included and analyzed retrospectively. Prior antiplatelet therapy was ascertained from the clinical history, and the patients included were divided into two groups: antiplatelet therapy and no antiplatelet therapy group. The in-hospital and follow-up outcomes were assessed with the Modified Rankin Scale and were compared between the 2 groups after 1:2 propensity score matching. RESULTS: Before the diagnosis of intracerebral hemorrhage, 21.8 % patients were not on antiplatelet therapy. Antiplatelet therapy group had larger hematoma volume (99.32 mL versus 73.75 mL) with no significant difference (P = 0.308). After propensity score matching, 42 patients were obtained. 4(9.5 %) had rehaemorrhage after surgery, and antiplatelet therapy was not related to higher rehaemorrhage rate (P = 0.628). After follow-up, the overall mortality was 29.3 %, and 22 patients (53.7 %) ended up with severe morbidity. In the multivariate regression, plasma fibrinogen was an independent predictor of both in-hospital and follow-up overall mortality (P = 0.044; P = 0.016), and prior antiplatelet therapy was found to predict better follow-up functional outcome independently (P = 0.032). CONCLUSION: Among surgically treated intracerebral hemorrhage patients, prior antiplatelet therapy did not increase hematoma volume, rehaemorrhage rate and mortality, and was related to lower follow-up severe morbidity independently.
OBJECTIVES: This study aimed to find the effect of antiplatelet therapy on hematoma volume, rehaemorrhage rate and prognosis of intracerebral hemorrhagepatients after surgery. PATIENTS AND METHODS: 101 surgically treated intracerebral hemorrhage subjects were included and analyzed retrospectively. Prior antiplatelet therapy was ascertained from the clinical history, and the patients included were divided into two groups: antiplatelet therapy and no antiplatelet therapy group. The in-hospital and follow-up outcomes were assessed with the Modified Rankin Scale and were compared between the 2 groups after 1:2 propensity score matching. RESULTS: Before the diagnosis of intracerebral hemorrhage, 21.8 % patients were not on antiplatelet therapy. Antiplatelet therapy group had larger hematoma volume (99.32 mL versus 73.75 mL) with no significant difference (P = 0.308). After propensity score matching, 42 patients were obtained. 4(9.5 %) had rehaemorrhage after surgery, and antiplatelet therapy was not related to higher rehaemorrhage rate (P = 0.628). After follow-up, the overall mortality was 29.3 %, and 22 patients (53.7 %) ended up with severe morbidity. In the multivariate regression, plasma fibrinogen was an independent predictor of both in-hospital and follow-up overall mortality (P = 0.044; P = 0.016), and prior antiplatelet therapy was found to predict better follow-up functional outcome independently (P = 0.032). CONCLUSION: Among surgically treated intracerebral hemorrhagepatients, prior antiplatelet therapy did not increase hematoma volume, rehaemorrhage rate and mortality, and was related to lower follow-up severe morbidity independently.