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Risk of haemorrhagic stroke in patients with oral anticoagulation compared with the general population

Sjalander, A; Engstrom, G; Berntorp, Erik LU and Svensson, Peter LU (2003) In Journal of Internal Medicine 254(5). p.434-438
Abstract
Objectives. To compare the incidence of haemorrhagic stroke (HS), and the risk of fatal outcome after HS in patients with oral anticoagulation (OA) treatment and in the general population. Design. Five-year cohort study. Setting. The Anticoagulation Clinic, Malmo University Hospital, Lund, Sweden. Subjects. A total of 4434 patients treated with OA (6693 treatment years) from 1 Oct 1993 to 30 Sept 1998. The population-based Stroke Register of Malmo, Lund, Sweden (STROMA). Results. Forty-eight patients had HS according to ICD 9 code 430 and 431. HS occurred at a higher age in women compared with men (mean age 79.5 years vs. 74.7 years, P = 0.009). The age-adjusted relative risk of HS during OA treatment was 10.9 (CI 6.7-17.6) for men and 9.3... (More)
Objectives. To compare the incidence of haemorrhagic stroke (HS), and the risk of fatal outcome after HS in patients with oral anticoagulation (OA) treatment and in the general population. Design. Five-year cohort study. Setting. The Anticoagulation Clinic, Malmo University Hospital, Lund, Sweden. Subjects. A total of 4434 patients treated with OA (6693 treatment years) from 1 Oct 1993 to 30 Sept 1998. The population-based Stroke Register of Malmo, Lund, Sweden (STROMA). Results. Forty-eight patients had HS according to ICD 9 code 430 and 431. HS occurred at a higher age in women compared with men (mean age 79.5 years vs. 74.7 years, P = 0.009). The age-adjusted relative risk of HS during OA treatment was 10.9 (CI 6.7-17.6) for men and 9.3 (CI 5.7-15.0) for women, as compared with the untreated general population. Number needed to harm (NNH) (person-years) was 103 for men and 188 for women. Adjusted for age and sex, OA treatment was significantly associated with fatal outcome in patients with HS (OR = 2.6, CI 1.4-4.8). Conclusions. Patients with OA treatment had approximately 10 times higher risk of HS as compared with the general population, and the risk increased markedly with age. OA treatment is associated with an increased case fatality in patients with HS. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
haemorrhagic stroke, oral anticoagulation, warfarin
in
Journal of Internal Medicine
volume
254
issue
5
pages
434 - 438
publisher
Wiley-Blackwell
external identifiers
  • wos:000185872500003
  • pmid:14535964
  • scopus:0242351842
ISSN
1365-2796
DOI
10.1046/j.1365-2796.2003.01209.x
language
English
LU publication?
yes
id
5aa2c1a9-f5ad-4efa-9009-35ad3c292a18 (old id 298326)
date added to LUP
2007-09-21 15:47:56
date last changed
2017-08-20 04:27:40
@article{5aa2c1a9-f5ad-4efa-9009-35ad3c292a18,
  abstract     = {Objectives. To compare the incidence of haemorrhagic stroke (HS), and the risk of fatal outcome after HS in patients with oral anticoagulation (OA) treatment and in the general population. Design. Five-year cohort study. Setting. The Anticoagulation Clinic, Malmo University Hospital, Lund, Sweden. Subjects. A total of 4434 patients treated with OA (6693 treatment years) from 1 Oct 1993 to 30 Sept 1998. The population-based Stroke Register of Malmo, Lund, Sweden (STROMA). Results. Forty-eight patients had HS according to ICD 9 code 430 and 431. HS occurred at a higher age in women compared with men (mean age 79.5 years vs. 74.7 years, P = 0.009). The age-adjusted relative risk of HS during OA treatment was 10.9 (CI 6.7-17.6) for men and 9.3 (CI 5.7-15.0) for women, as compared with the untreated general population. Number needed to harm (NNH) (person-years) was 103 for men and 188 for women. Adjusted for age and sex, OA treatment was significantly associated with fatal outcome in patients with HS (OR = 2.6, CI 1.4-4.8). Conclusions. Patients with OA treatment had approximately 10 times higher risk of HS as compared with the general population, and the risk increased markedly with age. OA treatment is associated with an increased case fatality in patients with HS.},
  author       = {Sjalander, A and Engstrom, G and Berntorp, Erik and Svensson, Peter},
  issn         = {1365-2796},
  keyword      = {haemorrhagic stroke,oral anticoagulation,warfarin},
  language     = {eng},
  number       = {5},
  pages        = {434--438},
  publisher    = {Wiley-Blackwell},
  series       = {Journal of Internal Medicine},
  title        = {Risk of haemorrhagic stroke in patients with oral anticoagulation compared with the general population},
  url          = {http://dx.doi.org/10.1046/j.1365-2796.2003.01209.x},
  volume       = {254},
  year         = {2003},
}