gms | German Medical Science

Objective: Favorable functional outcome in patients presenting with aneurysmal subarachnoid hemorrhage (SAH) is determined by several factors. Nevertheless, data on the influence of prior use of oral anticoagulation drugs on functional outcome in patients suffering from SAH is scarce. We therefore analyzed our institutional data.

Method: From January 2009 to April 2015, 455 patients suffering from aneurysmal SAH were admitted to our institution. Information, including patient characteristics, treatment modality, aneurysm size and location, radiological features, and functional neurological outcome were assessed and further analyzed. Outcome was assessed according to the modified Rankin Scale (mRS) at 6 months and stratified into favorable (mRS 0-2) versus unfavorable (mRS 3-6).

Results: Overall 16 of 455 patients suffering from aneurysmal SAH were on anticoagulation therapy prior to ictus (4%). Patients without anticogulation therapy were significantly younger compared to patients with anticoagulation therapy prior to SAH (p<0.0001). Furthermore, patients without anticogulation therapy presented in a significantly better clinical condition compared to patients with anticoagulation therapy prior to SAH (p=0.04). Additionally, patients without anticogulation therapy achieved significantly more often favorable functional outcome compared to patients with anticoagulation therapy prior to SAH (p=0.04). However, anticoagulation therapy was not identified as significant and independent predictor for unfavorable outcome in the multivariate analysis.

Conclusions: The present data suggests that anticoagulation therapy prior SAH is not an independent factor influencing functional outcome in patients suffering from SAH. Therefore, treatment should not be omitted. Nevertheless, cautious management is necessary in patients with known anticoagulation therapy prior to SAH.