A retrospective study of patients with intracerebral hemorrhage (ICH) suggests that patients who regularly used moderate doses of aspirin immediately prior to their event had a worse outcome than those who did not use aspirin. The Finnish study identified 208 patients with ICH from hospital or death records; the 3-month mortality was 33%. Independent risk factors for death were aspirin or warfarin use at the onset of ICH and an ICH score of >2 on admission.

Hematoma volume and impaired level of consciousness are the strongest predictors of outcome after spontaneous hemorrhage. Authors of an editorial article related to the study suggested that the results may lead to a therapeutic approach to ICH that includes rapid enhancement of platelet function to slow hematoma increase in patients with presumed platelet dysfunction due to the use of antiplatelet agents.

These results are in contrast to a later German study that found no increased risk with aspirin use.

Dr. Garrett is a clinical pharmacist practitioner at Cornerstone Health Care in High Point, NC.