Abstract 44: Influence of Antithrombotics on Outcome Following Subarachnoid Hemorrhage
Objective: This study seeks to investigate the impact of antithrombotics, including Aspirin, Clopidogrel, and Warfarin, on the severity of bleeding and outcomes in patients with subarachnoid hemorrhage (SAH). We hypothesize that patients with a history of antithrombotic use have a more severe injury from SAH.
Methods: Two hundred twenty-eight patients admitted to the Mayo Clinic Florida consecutively between July 2008 and July 2011 were studied retrospectively. Of this group, 77 patients had a known history of antithrombotic use while 151 did not. Both aneurysmal and non-aneurysmal cases were included in the study. Each patient’s Hunt and Hess Score, Fisher Grade, modified Rankin Scale (mRS) and Glasgow Coma Scale (GCS) were evaluated. Associations between history of antithrombotic use and severity of SAH were assessed using Spearman’s test of correlation and Mann-Whitney tests.
Results: There was strong evidence of higher mRS grades in patients with a history of antithrombotic use compared to other patients (Median: 3 vs. 2, P=0.001). There was no significant difference between patients with and without a history of antithrombotic use regarding SAH Fisher grade (Median: 3 vs. 3, P=0.31) and Hunt and Hess score (Median: 2 vs. 2, P=0.93). The difference in GCS score was not statistically significant (Median: 14 vs. 15, P=0.20).
Conclusion: This analysis found a significant effect of previous use of antithrombotics on overall outcome following SAH. Further analysis is needed to correlate the outcomes with specific medications and investigate the role of aggressive reversal of coagulopathy on overall outcomes.
- © 2012 by American Heart Association, Inc.