BACKGROUND Intracranial hemorrhage (ICH) is a serious, life-threatening, but fortunately rare complication of non-vitamin K oral anticoagulant (NOAC) therapy. There are limited data on NOAC-related ICH prognosis. METHODS All consecutive patients admitted to a single center due to acute NOAC-related ICH from September 2012 until the beginning of 2017 were included. Risk factors, type of NOAC, and location of ICH were evaluated. Risk for ischemic and bleeding events and clinical status upon admission and at discharge were evaluated using standard scales. RESULTS Thirty-four patients aged 77.8 ± 8.3 years with NOAC-related ICH were included. The main predisposing risk factors were age and arterial hypertension. The median CHA2DS2-VASc score was 3.4 and the median HAS-BLED score was 1.8. Eighteen patients were treated with rivaroxaban, 11 with dabigatran, and 5 with apixaban. Ten patients (29%) had a favorable outcome with a modified Rankin Scale score ≤2 and 13 patients (38%) died. The location of the ICH was mainly intraparenchymal and subdural. CONCLUSIONS Our retrospective single-center study shows that the mortality rate with NOAC-related ICH is <40%, which makes it comparable to that with vitamin K antagonist-related ICH.

中文翻译：

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与非维生素 K 口服抗凝剂相关的颅内出血后的早期结果。

背景颅内出血 (ICH) 是非维生素 K 口服抗凝剂 (NOAC) 治疗的严重、危及生命但幸运的是罕见的并发症。关于 NOAC 相关 ICH 预后的数据有限。方法 纳入 2012 年 9 月至 2017 年初因急性 NOAC 相关 ICH 连续入院的所有单中心患者。评估了危险因素、NOAC 类型和 ICH 的位置。使用标准量表评估入院和出院时缺血和出血事件的风险以及临床状态。结果 纳入了 34 名年龄为 77.8 ± 8.3 岁的 NOAC 相关 ICH 患者。主要的诱发危险因素是年龄和动脉高血压。CHA2DS2-VASc 评分中位数为 3.4，HAS-BLED 评分中位数为 1.8。18 名患者接受了利伐沙班治疗，达比加群11例，阿哌沙班5例。10 名患者 (29%) 获得了良好的结果，改良 Rankin 量表评分≤2，13 名患者 (38%) 死亡。ICH的位置主要是脑实质内和硬膜下。结论 我们的回顾性单中心研究表明，NOAC 相关 ICH 的死亡率<40%，这使其与维生素 K 拮抗剂相关 ICH 的死亡率相当。