Secular Trends in the Background of Intracerebral Hemorrhage from 2010 to 2015

Abstract

ObjectiveDirect oral anticoagulants (DOACs) were recently introduced for the clinical use in stroke prevention, and they are reported to show a lower risk of intracerebral hemorrhage (ICH) compared to warfarin. We were interested to know whether there is any change in clinical backgrounds of ICH patients to date. MethodsFrom 2010 to 2015, ICH patients admitted to our hospital were consecutively screened (n = 658). Hematoma size was assessed by brain computed tomography images on admission. Outcome was measured by the modified Rankin Scale, and favorable outcome was defined as modified Rankin Scale 0-2. Biennial trends were compared in 3 periods, P1: 2010-2011, P2: 2012-2013, and P3: 2014-2015. ResultsThe percentage of ICH patients taking antithrombotics had been slightly decreasing (P = .245: [P1] 33.0%, [P2] 27.4%, and [P3] 26.2%). The frequency of patients taking antiplatelets had significantly decreased (P = .001: [P1] 50.7%, [P2] 44.3%, and [P3] 22.8%), and those taking DOACs had significantly increased (P = .001: [P1] 1.4%, [P2] 4.9%, and [P3] 19.3%). Frequency of favorable outcomes in patients taking antithrombotics was slightly increased in P3 compared to P1 and P2 (23.3%, 21.1%, and 21.3%, respectively). There was no significant difference in hematoma size between patients taking warfarin and DOACs. ConclusionsNumber of ICH patients taking antithrombotics has been slightly decreasing and the percentage taking DOACs among ICH has been increasing for 6 years.