OBJECTIVE Patients receiving treatment with oral anticoagulants (OACs) are at risk of intracranial hemorrhage (ICH). In this study, we describe the epidemiological and clinical characteristics of patients receiving OACs who experience ICH and compare those receiving vitamin K antagonists (ICH-VKAs) with those receiving direct OACs (ICH-DOACs). METHODS We performed a national, multicenter, descriptive, observational, retrospective study of all adult patients receiving OACs who were admitted to the neurology department with ICH over a 1-year period. The study population was divided into 2 groups (ICH-VKAs and ICH-DOACs). Epidemiological, clinical, radiological, and therapy-related variables, as well as functional outcome, were compared at 3 months. A total of 366 cases were included (331 ICH-VKAs, 35 ICH- DOACs). RESULTS The crude annual incidence of OAC-induced ICH was 3.8 (95% CI, 2.78-3.41) per 100,000 inhabitants/year. The mean (± SD) age was greater for ICH-DOACs (81.5 ± 8.3 vs. 77.7 ± 8.3 years; p = 0.012). The median (IQR) volume of the hemorrhage was lower for ICH-DOACs (11 [30.8] vs. 25 [50.7] mL; p = 0.03). The functional independence rate at 3 months (modified Rankin Scale, mRS < 3) was similar in both groups, although stroke-related mortality was greater in ICH-VKAs (40 vs. 72.7%; p = 0.02). The most frequently indicated poststroke antithrombotic therapy was DOACs (38.7%). CONCLUSION We found that the incidence of OAC-induced ICH was greater than in previous studies. Hemorrhage volume and mortality were lower in ICH-DOACs than in ICH-VKAs. After stroke, DOACs were the most frequently indicated antithrombotic treatment.

中文翻译：

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西班牙与口服抗凝剂相关的颅内出血流行病学：抗凝并发症登记趋势 - TAC 2 研究。

目的 接受口服抗凝剂 (OAC) 治疗的患者存在颅内出血 (ICH) 的风险。在本研究中，我们描述了接受 OAC 的 ICH 患者的流行病学和临床特征，并将接受维生素 K 拮抗剂 (ICH-VKA) 的患者与接受直接 OAC (ICH-DOAC) 的患者进行比较。方法 我们进行了一项全国性、多中心、描述性、观察性、回顾性研究，对象为在 1 年内因 ICH 入住神经内科的所有接受 OAC 的成年患者。研究人群分为 2 组（ICH-VKA 和 ICH-DOAC）。在 3 个月时比较了流行病学、临床、放射学和治疗相关变量以及功能结果。共纳入 366 例（331 例 ICH-VKA，35 例 ICH-DOAC）。结果 OAC 诱发的 ICH 的粗年发病率为 3.8 (95% CI, 2.78-3.41)/100,000 居民/年。ICH-DOAC 的平均 (± SD) 年龄更大（81.5 ± 8.3 对 77.7 ± 8.3 岁；p = 0.012）。ICH-DOAC 的中位出血量 (IQR) 较低（11 [30.8] 对 25 [50.7] mL；p = 0.03）。3 个月时的功能独立率（改良 Rankin 量表，mRS < 3）在两组中相似，尽管 ICH-VKA 中卒中相关死亡率更高（40% vs. 72.7%；p = 0.02）。最常见的卒中后抗血栓治疗是 DOACs (38.7%)。结论 我们发现 OAC 诱发的 ICH 的发生率高于以前的研究。ICH-DOACs 的出血量和死亡率低于 ICH-VKAs。卒中后，DOACs 是最常用的抗血栓治疗方法。