論文種別	原著論文
言語種別	英語
表題	Comparing intracerebral hemorrhages associated with direct oral anticoagulants or warfarin.
掲載誌名	正式名：Neurology 略　 称：Neurology ISSNコード：1526632X/00283878
掲載区分	国外
巻・号・頁	90(13),pp.e1143-e1149
著者・共著者	Kurogi Ryota, Nishimura Kunihiro, Nakai Michikazu, Kada Akiko, Kamitani Satoru, Nakagawara Jyoji, Toyoda Kazunori, Ogasawara Kuniaki, Ono Junichi, Shiokawa Yoshiaki, Aruga Toru, Miyachi Shigeru, Nagata Izumi, Matsuda Shinya, Yoshimura Shinichi, Okuchi Kazuo, Suzuki Akifumi, Nakamura Fumiaki, Onozuka Daisuke, Ido Keisuke, Kurogi Ai, Mukae Nobutaka, Nishimura Ataru, Arimura Koichi, Kitazono Takanari, Hagihara Akihito, Iihara Koji,
発行年月	2018/03
概要	OBJECTIVES:This cross-sectional survey explored the characteristics and outcomes of direct oral anticoagulant (DOAC)-associated nontraumatic intracerebral hemorrhages (ICHs) by analyzing a large nationwide Japanese discharge database.METHODS:We analyzed data from 2,245 patients who experienced ICHs while taking anticoagulants (DOAC: 227; warfarin: 2,018) and were urgently hospitalized at 621 institutions in Japan between April 2010 and March 2015. We compared the DOAC- and warfarin-treated patients based on their backgrounds, ICH severities, antiplatelet therapies at admission, hematoma removal surgeries, reversal agents, mortality rates, and modified Rankin Scale scores at discharge.RESULTS:DOAC-associated ICHs were less likely to cause moderately or severely impaired consciousness (DOAC-associated ICHs: 31.3%; warfarin-associated ICHs: 39.4%; p = 0.002) or require surgical removal (DOAC-associated ICHs: 5.3%; warfarin-associated ICHs: 9.9%; p = 0.024) in the univariate analysis. Propensity score analysis revealed that patients with DOAC-associated ICHs also exhibited lower mortality rates within 1 day (odds ratio [OR] 4.96, p = 0.005), within 7 days (OR 2.29, p = 0.037), and during hospitalization (OR 1.96, p = 0.039).CONCLUSIONS:This nationwide study revealed that DOAC-treated patients had less severe ICHs and lower mortality rates than did warfarin-treated patients, probably due to milder hemorrhages at admission and lower hematoma expansion frequencies.
DOI	10.1212/WNL.0000000000005207
PMID	29490916