Evidence map›Paper›PMID 30690686›Full record

ArticleNeurocritical care2019

Clinical and Radiological Characteristics of Vitamin K Versus Non-Vitamin K Antagonist Oral Anticoagulation-Related Intracerebral Hemorrhage.

Małgorzata M Miller, Jessica Lowe, Muhib Khan, Muhammad U Azeem, Susanne Muehlschlegel, Adalia H Jun-O'Connell, Richard P Goddeau, Majaz Moonis, Danielle Gritters, Brian Silver and 1 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurocritical care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 41% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 1 country.

Małgorzata M MillerDepartment of Neurology, University of Massachusetts Medical School, Worcester, MA, USA. malgorzata.miller@umassmemorial.org.ORCID http://orcid.org/0000-0002-7445-6217
Jessica LoweDivision of Neurology, Neuroscience Institute, Spectrum Health, Grand Rapids, MI, USA.
Muhib KhanDivision of Neurology, Neuroscience Institute, Spectrum Health, Grand Rapids, MI, USA.
Muhammad U AzeemDepartment of Neurology, University of Massachusetts Medical School, Worcester, MA, USA.
Susanne MuehlschlegelDepartment of Neurology, University of Massachusetts Medical School, Worcester, MA, USA.
Adalia H Jun-O'ConnellDepartment of Neurology, University of Massachusetts Medical School, Worcester, MA, USA.
Richard P GoddeauDepartment of Neurology, University of Massachusetts Medical School, Worcester, MA, USA.
Majaz MoonisDepartment of Neurology, University of Massachusetts Medical School, Worcester, MA, USA.
Danielle GrittersSpectrum Health Office of Research, Spectrum Health, Grand Rapids, MI, USA.
Brian SilverDepartment of Neurology, University of Massachusetts Medical School, Worcester, MA, USA.
Nils HenningerDepartment of Neurology, University of Massachusetts Medical School, Worcester, MA, USA.
University of Massachusetts Chan Medical School · USSpectrum Health · US

Funding

Inhibiting axon degeneration in a mouse model of acute brain injury through deletion of Sarm1K08NS091499 · NINDS · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI HENNINGER, NILS · 2016 to 2020
$919k
Improving Clinical Decisions for Critically Ill Traumatic Brain Injury PatientsK23HD080971 · NICHD · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI MUEHLSCHLEGEL, SUSANNE · 2015 to 2019
$751k
NICHD NIH HHS K23 HD080971NINDS NIH HHS K08 NS091499
6 · The paper itself

Abstract

BACKGROUND/

objectiveRecent studies indicated that functional outcome after intracranial hemorrhage (ICH) related to direct oral anticoagulation (DOAC-ICH) is similar, if not better, than vitamin K antagonist (VKA)-related ICH (VKA-ICH) due to a smaller initial hematoma volume (HV). However, the association with hematoma expansion (HE) and location is not well understood.

methodsWe retrospectively analyzed 102 consecutive patients with acute non-traumatic ICH on oral anticoagulation therapy to determine HV and HE stratified by hematoma location, and the relation to the 90-day outcome.

resultsDOAC-ICH (n = 25) and VKA-ICH (n = 77) had a similar admission HV and HE (unadjusted p > 0.05, each). Targeted reversal strategies were used in 93.5% of VKA-ICH versus 8% of DOAC-ICH. After adjustment, an unfavorable 90-day functional outcome (modified Rankin scale score 4-6) was independently associated with a lower admission Glasgow Coma Scale score (OR 1.63; 95% CI 1.26-2.10; p < 0.001) and greater HV (OR 1.03; 95% confidence interval (CI) 1.00-1.05; p = 0.046). After exclusion of patients without follow-up head computed tomography to allow for adjustment by occurrence of HE, VKA-ICH was associated with an approximately 3.5 times greater odds for a poor 90-day outcome (OR 3.64; 95% CI 1.01-13.09; p = 0.048). However, there was no significant association of the oral anticoagulant strategy with 90-day outcome in the entire cohort (OR 2.85; 95% CI 0.69-11.86; p = 0.15).

conclusionsDOAC use did not relate to worse HE, HV, and functional outcome after ICH, adding to the notion that DOAC is a safe alternative to VKA even in the absence of access to targeted reversal strategies (which are still not universally available).

Indexed as

Administration, OralAgedAged, 80 and overAnticoagulantsFemaleHematomaHumansIntracranial HemorrhagesMaleRadiographyRetrospective StudiesStrokeVitamin KAnticoagulantsVitamin KDirect oral anticoagulantsIntracranial hemorrhageWarfarin

Identifiers

PMID30690686
PMCPMC6609471
OpenAlexW2911764760

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.