维生素K拮抗剂所致颅内出血患者的慢性抗凝控制质量。

IF 1.8 Q3 PERIPHERAL VASCULAR DISEASE Stroke Research and Treatment Pub Date : 2018-08-02 eCollection Date: 2018-01-01 DOI:10.1155/2018/5613103

Carlos Estevez-Fraga, Maria Molina-Sanchez, Rodrigo Alvarez-Velasco, Pablo Agüero-Rabes, Leticia Crespo-Araico, Elena Viedma-Guiard, Antonio Cruz-Culebras, Consuelo Matute, Rocio Vera, Alicia De Felipe-Mimbrera, Jaime Masjuan Vallejo

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引用次数: 1

摘要

使用维生素K拮抗剂(VKA)治疗的患者颅内出血(ICH)的风险增加。本研究的目的是确定vka相关性脑出血患者既往抗凝控制的质量。材料和方法:我们前瞻性评估了2013年至2016年期间卒中单元收治的所有连续的vka相关ICH患者。提取前7个月的人口统计学、临床和放射学变量以及连续的国际标准化比率(INR)。计算治疗范围内时间(TTR)、超过范围时间(TOR)、低于范围时间(TBR)和范围内INR百分比(PINRR)。结果和讨论:研究人群包括53例患者。平均年龄79岁;42%是女性。房颤48例，机械瓣膜5个。64.4%的患者到达时检测到治疗或治疗下INR (95% CI 2.7 - 3.2)。TTR为67.8% (95% CI: 60.2 ~ 75.6%)， PINRR为75% (95% CI: 49.9 ~ 100)。TOR为17.2% (95% CI: 10.4 ~ 23.9%)， TBR为17% (95% CI: 10.6 ~ 23.9%)。结论:vka相关性脑出血通常发生在良好的慢性抗凝控制的情况下。需要更新的风险评估方法。

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Quality of Chronic Anticoagulation Control in Patients with Intracranial Haemorrhage due to Vitamin K Antagonists.

Introduction: Patients treated with vitamin K antagonists (VKA) are at increased risk of intracranial haemorrhage (ICH). The purpose of our study was to determine the quality of previous anticoagulation control in patients with VKA-associated ICH.

Materials and methods: We prospectively assessed every consecutive patient admitted to our stroke unit with VKA-associated ICH between 2013 and 2016. Demographic, clinical, and radiological variables, as well as consecutive international normalized ratios (INR) during 7 previous months, were extracted. Time in therapeutic range (TTR), time over range (TOR), time below range (TBR), and percentage of INR within range (PINRR) were calculated.

Results and discussion: The study population comprised 53 patients. Mean age was 79 years; 42% were women. Forty-eight patients had atrial fibrillation (AF) and 5 mechanical prosthetic valves. Therapeutic or infratherapeutic INR on arrival was detected in 64.4% of patients (95% CI 2.7 to 3.2). TTR was 67.8% (95% CI: 60.2 to 75.6 %) and PINRR was 75% (95% CI: 49.9-100). TOR was 17.2% (95% CI: 10.4 to 23.9% ) and TBR was 17% (95% CI: 10.6 to 23.9%).

Conclusion: VKA-associated ICH happens usually in the context of good chronic anticoagulation control. Newer risk assessment methods are required.

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