In a new study, researchers identified risk factors for venous thromboembolism (VTE) in patients with intracerebral hemorrhage (ICH), and they also found that anticoagulation therapy for VTE in these patients has potential to be safe and effective. The study results were reported in the International Journal of General Medicine.
The researchers explained in their report that risk factors for VTE in patients who have had ICH have been poorly understood. Additionally, data on treatment of VTE in patients with ICH have also been limited, with current guidelines often not adopted in clinical practice because of limitations related to evidence.
For this retrospective cohort analysis, data on adult patients with ICH were obtained using the Medical Information Mart for Intensive Care III version 1.4 database, and records were searched for multiple outcomes related to VTE and survival. Included patients had survived day 2 of hospitalization. Multivariable logistic regression analysis was used to determine risk factors for VTE in patients with ICH. Kaplan-Meier survival analysis was used to assess prognosis with anticoagulation treatment for VTE in patients with ICH. Survival was evaluated during hospitalization and at multiple time points after admission, including 28 days, 90 days, 1 year, and 4 years after admission.
There were 848 patients with ICH identified in this study, and 69 patients with ICH had VTE and were evaluated in this analysis. Deep vein thrombosis was reported for 58 of these patients, 12 patients had pulmonary embolism, and 1 patient had both.
Multivariable analysis revealed multiple independent risk factors for VTE in patients with ICH. These included pulmonary circulation disease (odds ratio [OR], 28.717; 95% CI, 9.566-86.208; P =.000), malignancy (OR, 4.262; 95% CI, 2.263-8.027; P =.000), a hospitalization time of >16 days (OR, 2.548; 95% CI, 1.381-4.701; P =.003), coagulopathy (OR, 2.453; 95% CI, 1.098-5.483; P =.029), and an age of greater than 60 years (OR, 2.138; 95% CI, 1.087-4.207; P =.028).
In-hospital mortality rates were 17.86% for patients receiving anticoagulation therapy and 53.85% for those who did not receive anticoagulation (P =.0011). At each time point following admission, patients who received anticoagulation had a significantly lower mortality rate than did patients who were not given anticoagulation. At 28 days, the mortality rate was 21.43% for patients in the anticoagulation group, compared with 61.54% for those not given anticoagulation (P =.0005). At 4 years, the mortality rates were 57.14% for patients given anticoagulation and 84.62% for those not given anticoagulation (P =.0014).
“Our study revealed that malignancy, coagulopathy, age >60 years, hospitalization time >16 days and pulmonary circulation disease were independent risk factors for VTE in ICH patients, and using anticoagulation therapy for VTE in ICH patients may be safe and effective,” the researchers wrote in their report. However, they cautioned that further research is needed to verify these results.
Chu Q, Liao L, Wei W, et al. Venous thromboembolism in ICU patients with intracerebral hemorrhage: risk factors and the prognosis after anticoagulation therapy. Int J Gen Med. 2021;14:5397-5404. doi:10.2147/IJGM.S327676