Evaluation of oral anticoagulant and antiplatelet drug use in patients diagnosed with intracranial hemorrhage in the emergency department

In this study, the use of oral anticoagulant and/or antiplatelet drugs in patients diagnosed with intracranial hemorrhage who applied to the emergency department was examined, the effects were aimed to be investigated, and the results were planned to contribute to long-term treatment strategies. In this study, which was designed as a single-center retrospective observational study, the data of 296 patients over the age of 18, diagnosed with intracranial hemorrhage, who applied to the adult emergency department of Hacettepe University Faculty of Medicine between 01 June 2012 and 01 June 2022, were analyzed. Demographic characteristics of the patients, vital signs, admission; platelet, aPTT, INR, troponin values, medical history, anticoagulant, antiplatelet and antihypertensive medications used, brain computed tomography findings and follow-up imaging results, intracranial bleeding types, injury mechanisms, emergency room outcomes, in-hospitalization conditions, treatments given and 24-hour and 72-hour follow-up. The relationship between hourly mortality rates was examined. Of the patients included in the study, 46.7% were female and 53.3% were male. The median age of the patients was 69 years. Hypertension was the most common in 50.8% (n=150) of the disease history. It was determined that 40.3% of the patients were using at least one anticoagulant and/or antiaggregant. The most commonly used 30% (n=65) were acetylsalicylic acid and clopidogrel. In the second place, DMAH (Enoxaparin sodium, Bemiparin sodium) was found at a frequency of 9.8%, warfarin was found at a frequency of 9.5% and YOAC was detected at a frequency of 4%. Brain CT revealed intraparenchymal hemorrhage in 57%, subdural hemorrhage in 34.6%, subarachnoid hemorrhage in 25.1% and epidural hemorrhage in 3.1% of the patients. The 24-hour mortality rate was 3.9%; The 72-hour mortality rate was calculated as 21.6%. It was found that there was no relationship between the use of anticoagulants and/or antiaggregants and the first 24-hour mortality rate of the patients, but the first 72-hour mortality rate was higher (57.5%) in the group using anticoagulants and/or antiaggregants. Although the data obtained in our study showed that the use of antiaggregant and anticoagulant drugs did not increase the risk and severity of intracranial hemorrhage, widespread and large-series literature data show that anticoagulant and antiaggregant therapy pose a high risk for the development of intracranial hemorrhage. As a result, considering the high mortality and morbidity rates of intracranial hemorrhage, more studies are needed to observe the effects of these drugs on intracranial hemorrhage in a healthier way in the future due to the increasing prevalence of the use of anticoagulant antiaggregant drugs in the etiology. Keywords: Anticoagulant drug, antiaggregant drug, emergency room, intracranial hemorrhage, mortality