DOES ASPIRIN USE AFFECT ICH OUTCOME?
A retrospective study of patients with intracerebralhemorrhage (ICH) suggests that patients who regularlyused moderate doses of aspirin immediately prior totheir event had a worse outcome than those who didnot use aspirin. The Finnish study identified 208 patientswith ICH from hospital or death records; the 3-monthmortality was 33%. Independent risk factors for deathwere aspirin or warfarin use at the onset of ICH and anICH score of >2 on admission.
Hematoma volume and impaired level of consciousness are the strongest predictorsof outcome after spontaneous hemorrhage. Authors of an editorial articlerelated to the study suggested that the results may lead to a therapeutic approachto ICH that includes rapid enhancement of platelet function to slow hematomaincrease in patients with presumed platelet dysfunction due to the use ofantiplatelet agents.
These results are in contrast to a later German study that found no increasedrisk with aspirin use.
Dr. Garrett is a clinical pharmacistpractitioner at Cornerstone HealthCare in High Point, NC.