Abstract P451: Clinical Characteristics of Coagulopathic Intracranial Hemorrhages

Abstract

Introduction: Acute non-traumatic intracerebral hemorrhage (ICH) is the second-most common subtype of stroke and has a 40% mortality rate at one month. Non-iatrogenic coagulopathies comprise less than 20% of ICH and few studies have investigated characteristics of these groups. We compared baseline characteristics of individuals with ICH with and without non-iatrogenic coagulopathy. Methods: A retrospective study of 392 consecutive patients with ICHs between 2017 and 2019 were analyzed by the absence of coagulopathy, presence of anticoagulation and non-iatrogenic coagulopathy. Non-iatrogenic coagulopathy was defined as a prior documented coagulopathy (such as liver/kidney disease or cancer), platelets <100K, INR >2.0 or aPTT >60 seconds. Location(s) and size of abnormalities on prior imaging and presenting ICH were recorded. A two-tailed type 1 Student’s t -test (continuous variables), chi-squared test (categorical variables), Bonferroni corrections and Cramer’s V were used for statistical analyses. Preliminary Results: Of 392 patients with ICH, 28 (7.1%) were anti-coagulated and 29 (7.4%) had non-iatrogenic coagulopathy. There were lower/comparable rates of hypertension (83%, p=0.02 and p=0.25) and higher rates of alcohol use (28%, p=0.01 and p<0.01) and chronic kidney disease (38%, p<0.01 and p<0.01) in the non-iatrogenic coagulopathy compared to non-coagulopathic and anticoagulated groups, respectively. Highest baseline blood pressure was lower in the non-iatrogenic coagulopathy (systolic p=0.09, diastolic p=0.04) and anticoagulated groups (systolic p=0.02, diastolic p=0.22) compared to non-coagulopathic ICH. Conclusion: Our preliminary findings suggest that individuals with non-iatrogenic coagulopathy are as common as anticoagulated patients in our ICH cohort and have distinct clinical characteristics. Future directions, such as neuroimaging anaysis and assessment of functional outcomes, will determine if there are risk factors that would warrant distinct treatments beyond standard supportive management.