Abstract
This study examined the impact of platelet transfusion (PLT) on the survival of intracerebral hemorrhage (ICH) patients who had been administered anti-platelet agents (APA). This retrospective cohort analysis investigated 432 patients (259 men, 60%) who were newly diagnosed with ICH between January 2006 and June 2011 at the tertiary emergency center of Kitasato University Hospital. Median age on arrival was 67.0 years (range, 40–95 years). ICH was subcortical in 72 patients (16.7%), supratentorial in 233 (53.9%), and infratentorial in 133 (30.8%). PLT was performed in 16 patients (3.7%). Within 90 days after admission to the center, 178 patients (41.2%) had died due to ICH. Before the onset of ICH, 66 patients had been prescribed APA because of atherosclerotic diseases. Multivariate regression analysis indicated APA administration was an independent risk factor for death within 7 days (odds ratio, 5.12; P = 0.006) and within 90 days (hazard ratio, 1.87; P = 0.006) after arrival. Regarding the effect of a PLT in ICH patients with APA, no patient with PLT died. PLT had a survival benefit on patients with ICH, according to our analysis. Further prospective analysis is necessary to confirm the effects of PLT on survival in ICH with APA.
Highlights
For secondary prevention of many kinds of coronary heart disease (CHD) and thrombotic diseases [1,2], antithrombotic agents (ATA), including anti-platelet agents (APA) such as aspirin and anticoagulants such as warfarin, have been widely prescribed for patients, and sometimes two or more types of ATA are used concomitantly [1,2,3,4]
Regarding the reasons for APA administration, there was a statistically significantly greater incidence of diabetes mellitus (DM) (P = 0.047), coronary heart disease (CHD) (P,0.0001), and transient ischemic attack (TIA) (P,0.0001) among patients taking APAs compared with patients who were not (Table 1)
The decision to administer a platelet transfusion (PLT) to patients taking an APA was made by the attending doctors, who may have been concerned about bleeding tendencies due to APA
Summary
For secondary prevention of many kinds of coronary heart disease (CHD) and thrombotic diseases [1,2], antithrombotic agents (ATA), including anti-platelet agents (APA) such as aspirin and anticoagulants such as warfarin, have been widely prescribed for patients, and sometimes two or more types of ATA are used concomitantly [1,2,3,4]. Among patients receiving ATA, bleeding complications such as intracerebral hemorrhage (ICH) are becoming the issue of most concern. The Japanese population shows a relatively high incidence of ICH according to the Hisayama [5] and Shibata [6] studies. According to reports from the Japanese Ministry of Health, Labour, and Welfare, cerebrovascular disease (including ICH, cerebral infarction, and subarachnoid hemorrhage) is the third most common cause of death in Japan. In Japan as well as other countries, ICH is among the major causes of stroke. ICH is the second-most common cause of stroke in Italy [7], and is responsible for 15% of strokes reported in the USA [8]
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