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- Title
Sensitivity and specificity of blood-fluid levels for oral anticoagulant-associated intracerebral haemorrhage.
- Authors
Almarzouki, Abeer; Wilson, Duncan; Ambler, Gareth; Shakeshaft, Clare; Cohen, Hannah; Yousry, Tarek; Salman, Rustam Al-Shahi; Lip, Gregory Y. H.; Houlden, Henry; Brown, Martin M.; Muir, Keith W.; Jäger, Hans Rolf; Werring, David J.
- Abstract
Intracerebral haemorrhage (ICH) is a life-threatening emergency, the incidence of which has increased in part due to an increase in the use of oral anticoagulants. A blood-fluid level within the haematoma, as revealed by computed tomography (CT), has been suggested as a marker for oral anticoagulant-associated ICH (OAC-ICH), but the diagnostic specificity and prognostic value of this finding remains unclear. In 855 patients with CT-confirmed acute ICH scanned within 48 h of symptom onset, we investigated the sensitivity and specificity of the presence of a CT-defined blood-fluid level (rated blinded to anticoagulant status) for identifying concomitant anticoagulant use. We also investigated the association of the presence of a blood-fluid level with six-month case fatality. Eighteen patients (2.1%) had a blood-fluid level identified on CT; of those with a blood-fluid level, 15 (83.3%) were taking anticoagulants. The specificity of blood-fluid level for OAC-ICH was 99.4%; the sensitivity was 4.2%. We could not detect an association between the presence of a blood-fluid level and an increased risk of death at six months (OR = 1.21, 95% CI 0.28–3.88, p = 0.769). The presence of a blood-fluid level should alert clinicians to the possibility of OAC-ICH, but absence of a blood-fluid level is not useful in excluding OAC-ICH.
- Subjects
CEREBRAL hemorrhage; HEMATOMA; ANTICOAGULANTS; COMPUTED tomography; CEREBROVASCULAR disease
- Publication
Scientific Reports, 2020, Vol 10, Issue 1, pN.PAG
- ISSN
2045-2322
- Publication type
Article
- DOI
10.1038/s41598-020-72504-7