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

Area of Science:

• Neurology
• Cardiology
• Pharmacology

Background:

• Direct oral anticoagulants (DOACs) offer stroke prevention with a reported lower risk of intracerebral hemorrhage (ICH) compared to warfarin.
• Understanding evolving clinical trends in ICH patients is crucial for effective management and treatment strategies.

Purpose of the Study:

• To investigate changes in the clinical backgrounds of intracerebral hemorrhage (ICH) patients over a six-year period.
• To analyze trends in antithrombotic medication use, including direct oral anticoagulants (DOACs), among ICH patients.

Main Methods:

• A consecutive screening of 658 ICH patients admitted between 2010 and 2015.
• Assessment of hematoma size via brain computed tomography on admission.
• Comparison of trends across three biennial periods (2010-2011, 2012-2013, 2014-2015) using modified Rankin Scale for outcomes.

Main Results:

• A slight decrease in the overall percentage of ICH patients taking antithrombotics was observed (33.0% to 26.2%).
• A significant decrease in antiplatelet use (50.7% to 22.8%) contrasted with a significant increase in direct oral anticoagulant (DOAC) use (1.4% to 19.3%).
• Favorable outcomes slightly increased in the later period (23.3% in P3 vs. 21.1-21.3% in P1-P2); no significant difference in hematoma size between warfarin and DOAC users.

Conclusions:

• The proportion of intracerebral hemorrhage (ICH) patients using antithrombotics has slightly declined over six years.
• There has been a notable increase in the use of direct oral anticoagulants (DOACs) among ICH patients during the study period.
• These findings highlight a shift in anticoagulant prescribing patterns within the ICH patient population.