Reduced mortality and discharge to hospital seen with DTT of 60 minutes or less among ICH patients receiving anticoagulation reversal
By Elana Gotkine HealthDay Reporter
THURSDAY, Feb. 15, 2024 (HealthDay News) — For patients with anticoagulation-associated intracerebral hemorrhage (ICH), earlier door-to-treatment (DTT) time is associated with improved survival, according to a study published online Feb. 9 in JAMA Neurology to coincide with the annual American Stroke Association International Stroke Conference, held from Feb. 7 to 9 in Phoenix.
Kevin N. Sheth, M.D., from the Yale University School of Medicine in New Haven, Connecticut, and colleagues examined whether DTT time is associated with outcome among patients with anticoagulation-associated ICH treated with reversal interventions in a cohort study using data from the American Heart Association Get With The Guidelines-Stroke quality improvement registry. Data were included for 9,492 patients with anticoagulation-associated ICH and documented reversal intervention status.
Overall, 7,469 patients received reversal therapy, including 85.0 percent of the 5,429 patients taking warfarin and 70.2 percent of the 2,069 taking a non-vitamin K antagonist oral anticoagulant. The researchers found that the median onset-to-treatment time was 232 minutes and median DTT time was 82 minutes among the 5,224 patients taking a reversal intervention with documented workflow times. Overall, 27.7 percent had a DTT time of 60 minutes or less, which was associated with reduced mortality and discharge to hospital, but no difference in functional outcome. White race, higher systolic blood pressure, and lower stroke severity were seen in association with DTT time of 60 minutes or less.
“These findings support intensive efforts to accelerate evaluation and treatment for patients with this devastating form of stroke,” the authors write.
Several authors disclosed ties to biopharmaceutical companies, including AstraZeneca, which partially funded the study.
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