000255985 001__ 255985
000255985 005__ 20210129220601.0
000255985 0247_ $$2doi$$a10.1001/jama.2015.0846
000255985 0247_ $$2ISSN$$a0002-9955
000255985 0247_ $$2ISSN$$a0098-7484
000255985 0247_ $$2ISSN$$a0254-9077
000255985 0247_ $$2ISSN$$a1538-3598
000255985 0247_ $$2WOS$$aWOS:000349826400016
000255985 0247_ $$2altmetric$$aaltmetric:3728163
000255985 0247_ $$2pmid$$apmid:25710659
000255985 037__ $$aFZJ-2015-06043
000255985 041__ $$aEnglish
000255985 082__ $$a610
000255985 1001_ $$0P:(DE-HGF)0$$aKuramatsu, Joji B.$$b0$$eCorresponding author
000255985 245__ $$aAnticoagulant Reversal, Blood Pressure Levels, and Anticoagulant Resumption in Patients With Anticoagulation-Related Intracerebral Hemorrhage
000255985 260__ $$aChicago, Ill.$$bAmerican Medical Association$$c2015
000255985 3367_ $$0PUB:(DE-HGF)16$$2PUB:(DE-HGF)$$aJournal Article$$bjournal$$mjournal$$s1444051809_8726
000255985 3367_ $$2DataCite$$aOutput Types/Journal article
000255985 3367_ $$00$$2EndNote$$aJournal Article
000255985 3367_ $$2BibTeX$$aARTICLE
000255985 3367_ $$2ORCID$$aJOURNAL_ARTICLE
000255985 3367_ $$2DRIVER$$aarticle
000255985 520__ $$aImportance Although use of oral anticoagulants (OACs) is increasing, there is a substantial lack of data on how to treat OAC-associated intracerebral hemorrhage (ICH).Objective  To assess the association of anticoagulation reversal and blood pressure (BP) with hematoma enlargement and the effects of OAC resumption.Design, Setting, and Participants  Retrospective cohort study at 19 German tertiary care centers (2006-2012) including 1176 individuals for analysis of long-term functional outcome, 853 for analysis of hematoma enlargement, and 719 for analysis of OAC resumption.Exposures  Reversal of anticoagulation during acute phase, systolic BP at 4 hours, and reinitiation of OAC for long-term treatment.Main Outcomes and Measures  Frequency of hematoma enlargement in relation to international normalized ratio (INR) and BP. Incidence analysis of ischemic and hemorrhagic events with or without OAC resumption. Factors associated with favorable (modified Rankin Scale score, 0-3) vs unfavorable functional outcome.Results  Hemorrhage enlargement occurred in 307 of 853 patients (36.0%). Reduced rates of hematoma enlargement were associated with reversal of INR levels <1.3 within 4 hours after admission (43/217 [19.8%]) vs INR of ≥1.3 (264/636 [41.5%]; P < .001) and systolic BP <160 mm Hg at 4 hours (167/504 [33.1%]) vs ≥160 mm Hg (98/187 [52.4%]; P < .001). The combination of INR reversal <1.3 within 4 hours and systolic BP of <160 mm Hg at 4 hours was associated with lower rates of hematoma enlargement (35/193 [18.1%] vs 220/498 [44.2%] not achieving these values; OR, 0.28; 95% CI, 0.19-0.42; P < .001) and lower rates of in-hospital mortality (26/193 [13.5%] vs 103/498 [20.7%]; OR, 0.60; 95% CI, 0.37-0.95; P = .03). OAC was resumed in 172 of 719 survivors (23.9%). OAC resumption showed fewer ischemic complications (OAC: 9/172 [5.2%] vs no OAC: 82/547 [15.0%]; P < .001) and not significantly different hemorrhagic complications (OAC: 14/172 [8.1%] vs no OAC: 36/547 [6.6%]; P = .48). Propensity-matched survival analysis in patients with atrial fibrillation who restarted OAC showed a decreased HR of 0.258 (95% CI, 0.125-0.534; P < .001) for long-term mortality. Functional long-term outcome was unfavorable in 786 of 1083 patients (72.6%).Conclusions and Relevance  Among patients with OAC-associated ICH, reversal of INR <1.3 within 4 hours and systolic BP <160 mm Hg at 4 hours were associated with lower rates of hematoma enlargement, and resumption of OAC therapy was associated with lower risk of ischemic events. These findings require replication and assessment in prospective studies.
000255985 536__ $$0G:(DE-HGF)POF3-572$$a572 - (Dys-)function and Plasticity (POF3-572)$$cPOF3-572$$fPOF III$$x0
000255985 588__ $$aDataset connected to CrossRef
000255985 7001_ $$0P:(DE-HGF)0$$aGerner, Stefan T.$$b1
000255985 7001_ $$0P:(DE-HGF)0$$aSchellinger, Peter D.$$b2
000255985 7001_ $$0P:(DE-HGF)0$$aGlahn, Jörg$$b3
000255985 7001_ $$0P:(DE-HGF)0$$aEndres, Matthias$$b4
000255985 7001_ $$0P:(DE-HGF)0$$aSobesky, Jan$$b5
000255985 7001_ $$0P:(DE-HGF)0$$aFlechsenhar, Julia$$b6
000255985 7001_ $$0P:(DE-HGF)0$$aNeugebauer, Hermann$$b7
000255985 7001_ $$0P:(DE-HGF)0$$aJüttler, Eric$$b8
000255985 7001_ $$0P:(DE-HGF)0$$aGrau, Armin$$b9
000255985 7001_ $$0P:(DE-HGF)0$$aPalm, Frederick$$b10
000255985 7001_ $$0P:(DE-HGF)0$$aRöther, Joachim$$b11
000255985 7001_ $$0P:(DE-HGF)0$$aMichels, Peter$$b12
000255985 7001_ $$0P:(DE-HGF)0$$aHamann, Gerhard F.$$b13
000255985 7001_ $$0P:(DE-HGF)0$$aHüwel, Joachim$$b14
000255985 7001_ $$0P:(DE-HGF)0$$aHagemann, Georg$$b15
000255985 7001_ $$0P:(DE-HGF)0$$aBarber, Beatrice$$b16
000255985 7001_ $$0P:(DE-HGF)0$$aTerborg, Christoph$$b17
000255985 7001_ $$0P:(DE-HGF)0$$aTrostdorf, Frank$$b18
000255985 7001_ $$0P:(DE-HGF)0$$aBäzner, Hansjörg$$b19
000255985 7001_ $$0P:(DE-HGF)0$$aRoth, Aletta$$b20
000255985 7001_ $$0P:(DE-HGF)0$$aWöhrle, Johannes$$b21
000255985 7001_ $$0P:(DE-HGF)0$$aKeller, Moritz$$b22
000255985 7001_ $$0P:(DE-HGF)0$$aSchwarz, Michael$$b23
000255985 7001_ $$0P:(DE-HGF)0$$aReimann, Gernot$$b24
000255985 7001_ $$0P:(DE-HGF)0$$aVolkmann, Jens$$b25
000255985 7001_ $$0P:(DE-HGF)0$$aMüllges, Wolfgang$$b26
000255985 7001_ $$0P:(DE-HGF)0$$aKraft, Peter$$b27
000255985 7001_ $$0P:(DE-HGF)0$$aClassen, Joseph$$b28
000255985 7001_ $$0P:(DE-HGF)0$$aHobohm, Carsten$$b29
000255985 7001_ $$0P:(DE-HGF)0$$aHorn, Markus$$b30
000255985 7001_ $$0P:(DE-HGF)0$$aMilewski, Angelika$$b31
000255985 7001_ $$0P:(DE-HGF)0$$aReichmann, Heinz$$b32
000255985 7001_ $$0P:(DE-HGF)0$$aSchneider, Hauke$$b33
000255985 7001_ $$0P:(DE-HGF)0$$aSchimmel, Eik$$b34
000255985 7001_ $$0P:(DE-Juel1)131720$$aFink, Gereon R.$$b35$$ufzj
000255985 7001_ $$0P:(DE-HGF)0$$aDohmen, Christian$$b36
000255985 7001_ $$0P:(DE-HGF)0$$aStetefeld, Henning$$b37
000255985 7001_ $$0P:(DE-HGF)0$$aWitte, Otto$$b38
000255985 7001_ $$0P:(DE-HGF)0$$aGünther, Albrecht$$b39
000255985 7001_ $$0P:(DE-HGF)0$$aNeumann-Haefelin, Tobias$$b40
000255985 7001_ $$0P:(DE-HGF)0$$aRacs, Andras E.$$b41
000255985 7001_ $$0P:(DE-HGF)0$$aNueckel, Martin$$b42
000255985 7001_ $$0P:(DE-HGF)0$$aErbguth, Frank$$b43
000255985 7001_ $$0P:(DE-HGF)0$$aKloska, Stephan P.$$b44
000255985 7001_ $$0P:(DE-HGF)0$$aDörfler, Arnd$$b45
000255985 7001_ $$0P:(DE-HGF)0$$aKöhrmann, Martin$$b46
000255985 7001_ $$0P:(DE-HGF)0$$aSchwab, Stefan$$b47
000255985 7001_ $$0P:(DE-HGF)0$$aHuttner, Hagen B.$$b48
000255985 773__ $$0PERI:(DE-600)2018410-4$$a10.1001/jama.2015.0846$$gVol. 313, no. 8, p. 824 -$$n8$$p824 - 836$$tThe @journal of the American Medical Association$$v313$$x0098-7484$$y2015
000255985 909CO $$ooai:juser.fz-juelich.de:255985$$pVDB
000255985 9101_ $$0I:(DE-588b)5008462-8$$6P:(DE-Juel1)131720$$aForschungszentrum Jülich GmbH$$b35$$kFZJ
000255985 9131_ $$0G:(DE-HGF)POF3-572$$1G:(DE-HGF)POF3-570$$2G:(DE-HGF)POF3-500$$3G:(DE-HGF)POF3$$4G:(DE-HGF)POF$$aDE-HGF$$bKey Technologies$$lDecoding the Human Brain$$v(Dys-)function and Plasticity$$x0
000255985 9141_ $$y2015
000255985 915__ $$0StatID:(DE-HGF)0300$$2StatID$$aDBCoverage$$bMedline
000255985 915__ $$0StatID:(DE-HGF)0310$$2StatID$$aDBCoverage$$bNCBI Molecular Biology Database
000255985 915__ $$0StatID:(DE-HGF)0100$$2StatID$$aJCR$$bJAMA-J AM MED ASSOC : 2014
000255985 915__ $$0StatID:(DE-HGF)0200$$2StatID$$aDBCoverage$$bSCOPUS
000255985 915__ $$0StatID:(DE-HGF)0199$$2StatID$$aDBCoverage$$bThomson Reuters Master Journal List
000255985 915__ $$0StatID:(DE-HGF)0110$$2StatID$$aWoS$$bScience Citation Index
000255985 915__ $$0StatID:(DE-HGF)0150$$2StatID$$aDBCoverage$$bWeb of Science Core Collection
000255985 915__ $$0StatID:(DE-HGF)0111$$2StatID$$aWoS$$bScience Citation Index Expanded
000255985 915__ $$0StatID:(DE-HGF)1110$$2StatID$$aDBCoverage$$bCurrent Contents - Clinical Medicine
000255985 915__ $$0StatID:(DE-HGF)1030$$2StatID$$aDBCoverage$$bCurrent Contents - Life Sciences
000255985 915__ $$0StatID:(DE-HGF)1050$$2StatID$$aDBCoverage$$bBIOSIS Previews
000255985 915__ $$0StatID:(DE-HGF)9930$$2StatID$$aIF >= 30$$bJAMA-J AM MED ASSOC : 2014
000255985 920__ $$lyes
000255985 9201_ $$0I:(DE-Juel1)INM-3-20090406$$kINM-3$$lKognitive Neurowissenschaften$$x0
000255985 980__ $$ajournal
000255985 980__ $$aVDB
000255985 980__ $$aI:(DE-Juel1)INM-3-20090406
000255985 980__ $$aUNRESTRICTED