Incidencia y evitabilidad de los ictus hemorrágicos. Resultados del registro Ebrictus

Gonzalez-Henares, Antonia; Clúa-Espuny, Josep Lluís; Gil-Guillén, Vicente; Panisello-Tafalla, Anna; Queralt-Tomas, Maria Lluïsa; Ripolles-Vicente, Rosa; López-Pablo, Carlos; Lucas-Noll, Jorgina; Ebrictus, Equipo de Investigacion Ebrictus Equipo de Investigacion

doi:10.33588/rn.6209.2015470

Cited by 2 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The results of the present study indicate a higher incidence of ICH in an emerging and vulnerable population subgroup, such as CCPs, than in both general and elderly populations. Data on time trends for ICH in the general population indicate no significant changes in the incidence of ICH over the last two decades [6,15], but the incidence density of ICH was 5to-60-fold higher than that observed in the general population, both within the study area and worldwide (Table 6) [6,[16][17][18][19][20][21][22][23][24]. Comparisons between studies are difficult due to several interacting and overlapping emerging risk factors and aetiologies, new imaging techniques, demographic changes, comorbidities and associated treatments, different target populations, and the lack of a standardized methodology for data recording and exploitation, which makes it impossible to make adjustments to the incidences for different series of patients.…”

Section: Discussionmentioning

confidence: 84%

“…Despite its low estimated discriminative power, a HAS-BLED score ≥ 3 showed high sensitivity and a negative predictive value for the risk of ICH. This result is of special interest from a clinical point of view because it introduces the concept of "unnecessarily premature and avoidable mortality" for an episode of ICH as an indicator of the healthcare that these patients receive [18,37]. Further research related to the sensitivity and specificity of the HAS-BLED score for the identification of ICH risk in CCPs should be performed to detect the best cut-off point for not only detection but also strategy planning.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Complex chronic patients as an emergent group with high risk of intracerebral haemorrhage: an observational cohort study

Lorman-Carbo¹,

Clúa-Espuny²,

Muria-Subirats³

et al. 2021

BMC Geriatr

View full text Add to dashboard Cite

Background Demographic aging is a generalised event and the proportion of older adults is increasing rapidly worldwide with chronic pathologies, disability, and complexity of health needs. The intracerebral haemorrhage (ICH) has devastating consequences in high risk people. This study aims to quantify the incidence of ICH in complex chronic patients (CCP). Methods This is a multicentre, retrospective and community-based cohort study of 3594 CCPs followed up from 01/01/2013 to 31/12/2017 in primary care without a history of previous ICH episode. The cases were identified from clinical records encoded with ICD-10 (10th version of the International Classification of Diseases) in the e-SAP database of the Catalan Health Institute. The main variable was the ICH episode during the study period. Demographic, clinical, functional, cognitive and pharmacological variables were included. Descriptive and logistic regression analyses were carried out to identify the variables associated with suffering an ICH. The independent risk factors were obtained from logistic regression models, ruling out the variables included in the HAS-BLED score, to avoid duplication effects. Results are presented as odds ratio (OR) and 95% confidence interval (CI). The analysis with the resulting model was also stratified by sex. Results 161 (4.4%) participants suffered an ICH episode. Mean age 87 ± 9 years; 55.9% women. The ICH incidence density was 151/10000 person-years [95%CI 127–174], without differences by sex. Related to subjects without ICH, presented a higher prevalence of arterial hypertension (83.2% vs. 74.9%; p = 0.02), hypercholesterolemia (55.3% vs. 47.4%, p = 0.05), cardiovascular disease (36.6% vs. 28.9%; p = 0.03), and use of antiplatelet drugs (64.0% vs. 52.9%; p = 0.006). 93.2% had a HAS-BLED score ≥ 3. The independent risk factors for ICH were identified: HAS-BLED ≥3 [OR 3.54; 95%CI 1.88–6.68], hypercholesterolemia [OR 1.62; 95%CI 1.11–2.35], and cardiovascular disease [OR 1.48 IC95% 1.05–2.09]. The HAS_BLED ≥3 score showed a high sensitivity [0.93 CI95% 0.89–0.97] and negative predictive value [0.98 (CI95% 0.83–1.12)]. Conclusions In the CCP subgroup the incidence density of ICH was 5–60 times higher than that observed in elder and general population. The use of bleeding risk score as the HAS-BLED scale could improve the preventive approach of those with higher risk of ICH. Trial registration This study was retrospectively registered in ClinicalTrials.gov (NCT03247049) on August 11/2017.

show abstract

Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Complex chronic patients as an emergent group with high risk of intracerebral haemorrhage: an observational cohort study

Lorman-Carbo¹,

Clúa-Espuny²,

Muria-Subirats³

et al. 2021

BMC Geriatr

View full text Add to dashboard Cite

show abstract

Relationship between Hemorrhagic Stroke and Mortality in Chronic Complex Outpatients: Results from a Community Cohort of Patients

Ma¹,

Jl²,

Mll³

et al. 2017

J Aging Sci

View full text Add to dashboard Cite

Question: Around 3-5% of people can be identified as chronic complex patients(CCP) and are increasingly at risk of hemorrhagic stroke.The main objective was to explore differences in risk factors and the association with outcome factors on mortality. Materials and Methods:Multicenter and prospective cohort study from January 1 2013 to September 30 2016 among patients registered as chronic complex outpatients. To predict hazard ratios, mean survival time, and survival probabilities, multivariate Cox regression was used.Results: 932 CCP were included (52.3% women). Average age was 82.5 years (95% CI 81.8-83.2). During a mean follow-up period of 2.8 years, 65 (6.98%) stroke episodes happened (37 (56.9%) ischemic; 28 (43.1%) hemorrhagic). The percentage of ICH almost doubled (21.0% to 43.1) after CCP diagnosis; 26.1% had polypharmacy (≥ 10), 57.6% VKA-treated patientsshowed TTR <60%, and had a higher incidence of falling (31.9% vs. 19.2%, p 0.002).The average survival time was significantly shorter associated with age (HR 1.03 95% CI 1.14-1.53, p 0.001), previous stroke (HR 13.54 95%, p<0.001), antiagreggant treatment (HR 1.97 95% CI 1.21-3.21, p 0.006), anticoagulant treatment (HR 1.78 95%, CI 1.22-2.60, p 0.002), and Barthel score <60 (HR 1.43 95% CI 1.04-1.97, p 0.024). Conclusions:Given the co-occurrence of hemorrhagic strokes with poor performance status, multi-morbidity, and polypharmacy, multi-dimensional interventions are needed to improve health outcomes.

show abstract

Incidencia y evitabilidad de los ictus hemorrágicos. Resultados del registro Ebrictus

Cited by 2 publications

References 0 publications

Complex chronic patients as an emergent group with high risk of intracerebral haemorrhage: an observational cohort study

Complex chronic patients as an emergent group with high risk of intracerebral haemorrhage: an observational cohort study

Relationship between Hemorrhagic Stroke and Mortality in Chronic Complex Outpatients: Results from a Community Cohort of Patients

Contact Info

Product

Resources

About