What question did this study set out to answer?

To balance the risk of thromboembolic events after stopping oral anticoagulants against the risk of recurrent bleeding when restarting them following an intracranial haemorrhage.

January 1, 2005Acta chirurgica Belgica

Risk Analysis of Thrombo-Embolic and Recurrent Bleeding Events in the Management Of Intracranial Haemorrhage Due to Oral Anticoagulation

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Why the study?

Does restarting OAC compared to permanent cessation affect the risk of thrombo-embolic and recurrent bleeding events in patients with OAC-related intracranial haemorrhage?

Population

108 consecutive patients with oral anticoagulant (OAC)-related intracranial haemorrhage

Comparison

Restarting oral anticoagulants (OAC) vs Permanent cessation of oral anticoagulants (OAC)

Design

Cohort

Authors

SVSteven De VleeschouwerAllen Institute for Brain Science FCFrank Van CalenberghUniversitair Ziekenhuis Leuven JLJ. van LoonEuropean Respiratory Society

Discussion

Member takes

Implication

Supports safe temporary OAC withholding post-ICH with low thrombotic rates; leaves open resumption benefits versus bleeding risks in randomized trials.

Key Points

To balance the risk of thromboembolic events after stopping oral anticoagulants against the risk of recurrent bleeding when restarting them following an intracranial haemorrhage.
Conducted a prospective observational study of a consecutive series of 108 patients admitted with oral anticoagulant-related intracranial haemorrhage.
Assessed thrombotic event rates and recurrent bleeding rates during follow-up among patients who resumed oral anticoagulants versus those who did not.
Thrombo-embolic complications occurred at an overall rate of 0.66 events per 1,000 patient-days (95% CI: 0.3 to 1.3), with 0 events per 506 patient-days in restarted patients (n=25) versus 8 events per 11,590 patient-days in non-restarted patients (n=81).
Recurrent intracranial bleeding occurred in 8 patients (2 fatal), with 7 of the 8 recurrences happening before oral anticoagulants were restarted.

Structured PICO

Does restarting OAC compared to permanent cessation affect the risk of thrombo-embolic and recurrent bleeding events in patients with OAC-related intracranial haemorrhage?

Population

108 consecutive patients with oral anticoagulant (OAC)-related intracranial haemorrhage

Intervention

Restarting oral anticoagulants (OAC)

Comparator

Permanent cessation of oral anticoagulants (OAC)

Outcome

Thrombotic event rate and recurrent intracranial bleeding rate during follow-uphard clinical

Following OAC-related intracranial hemorrhage, OAC can be safely withheld for a considerable period with a very low thrombotic event rate, and the recurrent bleeding risk after restarting OAC is low.

Cite This Study

Vleeschouwer et al. (2005) studied this question.

synapsesocial.com/papers/6a7a902277336a1bae02dd74 https://doi.org/10.1080/00015458.2005.11679715

Topics

Anticoagulation in AF

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Implication

Supports safe temporary OAC withholding post-ICH with low thrombotic rates; leaves open resumption benefits versus bleeding risks in randomized trials.

Risk Analysis of Thrombo-Embolic and Recurrent Bleeding Events in the Management Of Intracranial Haemorrhage Due to Oral Anticoagulation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Risk Analysis of Thrombo-Embolic and Recurrent Bleeding Events in the Management Of Intracranial Haemorrhage Due to Oral Anticoagulation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider