Zubkov et al identified factors associated with a poor outcome for a patient with intracerebral hemorrhage (ICH) associated with warfarin therapy. These factors can help to identify a patient who may benefit from more aggressive management. The authors are from the Mayo Clinic in Rochester.
Outcomes measured:
(1) 7 day mortality rate
(2) functional outcome at hospital discharge
(3) long-term outcome (30 days or more)
Parameters affecting long-term outcome:
(1) volume of the intracerebral hemorrhage
(2) level of consciousness at presentation as measured with the Glasgow Coma Score
Parameter
Better Outcome
Worse Outcome
volume of the hemorrhage
small (mean 6 mL)
large (mean 18 mL)
Glasgow Coma Score
higher (mean 14)
lower
where:
• The data makes selection of cutoffs a bit challenging. For the implementation cutoffs for worse prognosis are > 10 mL ICH and < 13 GCS.
Factors not identified as predictors in multivariate analysis of long-term outcome:
(1) glucose level
(2) magnitude of the INR on admission
(3) rapidity of INR correction
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