INTRACEREBRALNO KRVARENJE I PRIMENA RAZLIČITIH VRSTA ANTIKOAGULANASA – KLINIČKA PREZENTACIJA I ISHODI LEČENJA
Sažetak
Uvod: Antikoagulantna terapija igra ključnu ulogu u prevenciji i tretmanu različitih vaskularnih oboljenja, ali istovremeno povećava rizik od hemoragijskih komplikacija, uključujući intracerebralnu hemoragiju (ICH). Cilj ovog rada bio je ispitati ishod pacijenata sa ICH u zavisnosti od prethodne antikoagulantne terapije.
Metode: U pitanju je retrospektivna kohortna studija u koju je od 277 pacijenata sa ICH iz bolničkog registra lečenih od januara do novembra 2024. godine u Specijalnoj bolnici za cerebrovaskularne bolesti „Sveti Sava”, uključeno njih 37. Svi pacijenti podeljeni su u dve grupe, na pacijente lečene antagonistima vitamina K (VKA) ili direktnim oralnim antikoagulansima (NOAK). Ishod lečenja pacijenata na otpustu i 90 dana nakon otpusta određivan je na osnovu modifikovane Rankin skale (mRS).
Rezultati: U grupi pacijenata prethodno lečenih VKA srednja vrednost mRS skora na otpustu bila je 4,6 ± 1,8, dok je u grupi prethodno lečenih NOAK terapijom ona iznosila 5,1 ± 1,7, što je bez statističke značajnosti između grupa (p = 0,442). Takođe statistička značajnost nije pronađena ni među mRS 90 dana nakon otpusta (p = 341). U grupi VKA-ICH srednja vrednost je iznosila 4,3 ± 2,2, dok je u drugoj grupi ona iznosila 4,9 ± 2. U prvoj grupi procenat letalnih ishoda bio je 58%, dok je u drugoj grupi 76%.
Zaključak: Pacijenti sa ICH i prethodnom terapijom VKA u odnosu na pacijente sa prethodnom NOAK terapijom su bez značajnih razlika u ishodu lečenja.
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