Impact of Platelet Transfusion on Intracerebral Hemorrhage in Patients on Antiplatelet Therapy–An Analysis Based on Intracerebral Hemorrhage Score

Gregory Arnone, Prateek Kumar, Matt C. Wonais, Darian R. Esfahani, Sally A. Campbell-Lee, Fady T. Charbel, Sepideh Amin-Hanjani, Ali Alaraj, Andreea Seicean, Ankit I. Mehta

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective: Platelet transfusions for patients with intracerebral hemorrhage (ICH) on antiplatelet therapy (APT) remain controversial. Diverging past research and differences in platelet preparation warrant further investigation of this topic. In this study, the association between platelet transfusion and clinical outcomes of ICH is investigated in patients matched by ICH score, a validated predictor of mortality. Methods: A consecutive review of all patients from 2012 to 2015 with nontraumatic ICH was performed. Risk factors including demographics, medical comorbidities, APT use, and ICH score were reviewed. Standardized differences were used to assess baseline characteristics; logistic regression models were performed to determine whether platelet transfusions were associated with adverse outcomes, both before and after matching for ICH score. Results: A total of 538 patients with nontraumatic ICH were investigated. Of these, 168 were on APT; 71 were excluded. Thirty-nine patients (40%) received platelet transfusions and 58 (60%) did not. An overall mortality of 9.3% was measured, with 29.9% of patients enduring complications. In the unmatched cohort, patients who received platelet transfusions were more likely to deteriorate (odds ratio [OR], 4.7), undergo surgical intervention during their hospital stay (OR, 7.2), be discharged with a worse modified Rankin Scale score (OR, 3.6), or die (OR, 6.1). After matching by ICH score, platelet transfusion was not a significant predictor for any negative outcome. Conclusions: This is the first analysis of platelet transfusions in patients with ICH based on ICH score. For patients on APT, platelet transfusion is not associated with clinical outcomes in an ICH score–matched sample.

Original languageEnglish (US)
Pages (from-to)e895-e904
JournalWorld neurosurgery
Volume111
DOIs
StatePublished - Mar 1 2018

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Platelet Transfusion
Cerebral Hemorrhage
Odds Ratio
Logistic Models
Mortality
Therapeutics
Comorbidity
Length of Stay
Blood Platelets
Demography

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

Arnone, Gregory ; Kumar, Prateek ; Wonais, Matt C. ; Esfahani, Darian R. ; Campbell-Lee, Sally A. ; Charbel, Fady T. ; Amin-Hanjani, Sepideh ; Alaraj, Ali ; Seicean, Andreea ; Mehta, Ankit I. / Impact of Platelet Transfusion on Intracerebral Hemorrhage in Patients on Antiplatelet Therapy–An Analysis Based on Intracerebral Hemorrhage Score. In: World neurosurgery. 2018 ; Vol. 111. pp. e895-e904.
@article{a0c267c79b7d4fb19b40b5de1ab96ec0,
title = "Impact of Platelet Transfusion on Intracerebral Hemorrhage in Patients on Antiplatelet Therapy–An Analysis Based on Intracerebral Hemorrhage Score",
abstract = "Objective: Platelet transfusions for patients with intracerebral hemorrhage (ICH) on antiplatelet therapy (APT) remain controversial. Diverging past research and differences in platelet preparation warrant further investigation of this topic. In this study, the association between platelet transfusion and clinical outcomes of ICH is investigated in patients matched by ICH score, a validated predictor of mortality. Methods: A consecutive review of all patients from 2012 to 2015 with nontraumatic ICH was performed. Risk factors including demographics, medical comorbidities, APT use, and ICH score were reviewed. Standardized differences were used to assess baseline characteristics; logistic regression models were performed to determine whether platelet transfusions were associated with adverse outcomes, both before and after matching for ICH score. Results: A total of 538 patients with nontraumatic ICH were investigated. Of these, 168 were on APT; 71 were excluded. Thirty-nine patients (40{\%}) received platelet transfusions and 58 (60{\%}) did not. An overall mortality of 9.3{\%} was measured, with 29.9{\%} of patients enduring complications. In the unmatched cohort, patients who received platelet transfusions were more likely to deteriorate (odds ratio [OR], 4.7), undergo surgical intervention during their hospital stay (OR, 7.2), be discharged with a worse modified Rankin Scale score (OR, 3.6), or die (OR, 6.1). After matching by ICH score, platelet transfusion was not a significant predictor for any negative outcome. Conclusions: This is the first analysis of platelet transfusions in patients with ICH based on ICH score. For patients on APT, platelet transfusion is not associated with clinical outcomes in an ICH score–matched sample.",
author = "Gregory Arnone and Prateek Kumar and Wonais, {Matt C.} and Esfahani, {Darian R.} and Campbell-Lee, {Sally A.} and Charbel, {Fady T.} and Sepideh Amin-Hanjani and Ali Alaraj and Andreea Seicean and Mehta, {Ankit I.}",
year = "2018",
month = "3",
day = "1",
doi = "10.1016/j.wneu.2018.01.006",
language = "English (US)",
volume = "111",
pages = "e895--e904",
journal = "World Neurosurgery",
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Arnone, G, Kumar, P, Wonais, MC, Esfahani, DR, Campbell-Lee, SA, Charbel, FT, Amin-Hanjani, S, Alaraj, A, Seicean, A & Mehta, AI 2018, 'Impact of Platelet Transfusion on Intracerebral Hemorrhage in Patients on Antiplatelet Therapy–An Analysis Based on Intracerebral Hemorrhage Score', World neurosurgery, vol. 111, pp. e895-e904. https://doi.org/10.1016/j.wneu.2018.01.006

Impact of Platelet Transfusion on Intracerebral Hemorrhage in Patients on Antiplatelet Therapy–An Analysis Based on Intracerebral Hemorrhage Score. / Arnone, Gregory; Kumar, Prateek; Wonais, Matt C.; Esfahani, Darian R.; Campbell-Lee, Sally A.; Charbel, Fady T.; Amin-Hanjani, Sepideh; Alaraj, Ali; Seicean, Andreea; Mehta, Ankit I.

In: World neurosurgery, Vol. 111, 01.03.2018, p. e895-e904.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Impact of Platelet Transfusion on Intracerebral Hemorrhage in Patients on Antiplatelet Therapy–An Analysis Based on Intracerebral Hemorrhage Score

AU - Arnone, Gregory

AU - Kumar, Prateek

AU - Wonais, Matt C.

AU - Esfahani, Darian R.

AU - Campbell-Lee, Sally A.

AU - Charbel, Fady T.

AU - Amin-Hanjani, Sepideh

AU - Alaraj, Ali

AU - Seicean, Andreea

AU - Mehta, Ankit I.

PY - 2018/3/1

Y1 - 2018/3/1

N2 - Objective: Platelet transfusions for patients with intracerebral hemorrhage (ICH) on antiplatelet therapy (APT) remain controversial. Diverging past research and differences in platelet preparation warrant further investigation of this topic. In this study, the association between platelet transfusion and clinical outcomes of ICH is investigated in patients matched by ICH score, a validated predictor of mortality. Methods: A consecutive review of all patients from 2012 to 2015 with nontraumatic ICH was performed. Risk factors including demographics, medical comorbidities, APT use, and ICH score were reviewed. Standardized differences were used to assess baseline characteristics; logistic regression models were performed to determine whether platelet transfusions were associated with adverse outcomes, both before and after matching for ICH score. Results: A total of 538 patients with nontraumatic ICH were investigated. Of these, 168 were on APT; 71 were excluded. Thirty-nine patients (40%) received platelet transfusions and 58 (60%) did not. An overall mortality of 9.3% was measured, with 29.9% of patients enduring complications. In the unmatched cohort, patients who received platelet transfusions were more likely to deteriorate (odds ratio [OR], 4.7), undergo surgical intervention during their hospital stay (OR, 7.2), be discharged with a worse modified Rankin Scale score (OR, 3.6), or die (OR, 6.1). After matching by ICH score, platelet transfusion was not a significant predictor for any negative outcome. Conclusions: This is the first analysis of platelet transfusions in patients with ICH based on ICH score. For patients on APT, platelet transfusion is not associated with clinical outcomes in an ICH score–matched sample.

AB - Objective: Platelet transfusions for patients with intracerebral hemorrhage (ICH) on antiplatelet therapy (APT) remain controversial. Diverging past research and differences in platelet preparation warrant further investigation of this topic. In this study, the association between platelet transfusion and clinical outcomes of ICH is investigated in patients matched by ICH score, a validated predictor of mortality. Methods: A consecutive review of all patients from 2012 to 2015 with nontraumatic ICH was performed. Risk factors including demographics, medical comorbidities, APT use, and ICH score were reviewed. Standardized differences were used to assess baseline characteristics; logistic regression models were performed to determine whether platelet transfusions were associated with adverse outcomes, both before and after matching for ICH score. Results: A total of 538 patients with nontraumatic ICH were investigated. Of these, 168 were on APT; 71 were excluded. Thirty-nine patients (40%) received platelet transfusions and 58 (60%) did not. An overall mortality of 9.3% was measured, with 29.9% of patients enduring complications. In the unmatched cohort, patients who received platelet transfusions were more likely to deteriorate (odds ratio [OR], 4.7), undergo surgical intervention during their hospital stay (OR, 7.2), be discharged with a worse modified Rankin Scale score (OR, 3.6), or die (OR, 6.1). After matching by ICH score, platelet transfusion was not a significant predictor for any negative outcome. Conclusions: This is the first analysis of platelet transfusions in patients with ICH based on ICH score. For patients on APT, platelet transfusion is not associated with clinical outcomes in an ICH score–matched sample.

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U2 - 10.1016/j.wneu.2018.01.006

DO - 10.1016/j.wneu.2018.01.006

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VL - 111

SP - e895-e904

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