Author, as appears in the article.: Lorman-Carbo, Blanca; Lluis Clua-Espuny, Josep; Muria-Subirats, Eulalia; Ballesta-Ors, Juan; Antonia Gonzalez-Henares, Maria; Fernandez-Saez, Jose; Martin-Lujan, Francisco M.;Ebrictus Res Grp
Department: Medicina i Cirurgia
URV's Author/s: Lorman Carbó, Blanca / Martín Lujan, Francisco Manuel
Keywords: Very elderly Trends Stroke Secondary prevention Risk factors Risk factor Retrospective study Retrospective studies Predictive value of tests Predictive value Mortality Modified rankin scale Male Intracerebral haemorrhage Humans Human Health Has-bled score Female Complex chronic patient Cohort studies Cohort analysis Cerebral hemorrhage Case-fatality Cardiovascular Brain hemorrhage Association Aspirin Aged, 80 and over Aged
Abstract: BackgroundDemographic aging is a generalised event and the proportion of older adults is increasing rapidly worldwide with chronic pathologies, disability, and complexity of health needs. The intracerebral haemorrhage (ICH) has devastating consequences in high risk people. This study aims to quantify the incidence of ICH in complex chronic patients (CCP).MethodsThis is a multicentre, retrospective and community-based cohort study of 3594 CCPs followed up from 01/01/2013 to 31/12/2017 in primary care without a history of previous ICH episode. The cases were identified from clinical records encoded with ICD-10 (10th version of the International Classification of Diseases) in the e-SAP database of the Catalan Health Institute. The main variable was the ICH episode during the study period. Demographic, clinical, functional, cognitive and pharmacological variables were included. Descriptive and logistic regression analyses were carried out to identify the variables associated with suffering an ICH. The independent risk factors were obtained from logistic regression models, ruling out the variables included in the HAS-BLED score, to avoid duplication effects. Results are presented as odds ratio (OR) and 95% confidence interval (CI). The analysis with the resulting model was also stratified by sex.Results161 (4.4%) participants suffered an ICH episode. Mean age 879years; 55.9% women. The ICH incidence density was 151/10000 person-years [95%CI 127-174], without differences by sex. Related to subjects without ICH, presented a higher prevalence of arterial hypertension (83.2% vs. 74.9%; p=0.02), hypercholesterolemia (55.3% vs. 47.4%, p=0.05), cardiovascular disease (36.6% vs. 28.9%; p=0.03), and use of antiplatelet drugs (64.0% vs. 52.9%; p=0.006). 93.2% had a HAS-BLED score >= 3. The independent risk factors for ICH were identified: HAS-BLED >= 3 [OR 3.54; 95%CI 1.88-6.68], hypercholesterolemia [OR 1.62; 95%CI 1.11-2.35], and cardiovascular disease [OR 1.48 IC95% 1.05-2.09]. The HAS_BLED >= 3 score showed a high sensitivity [0.93 CI95% 0.89-0.97] and negative predictive value [0.98 (CI95% 0.83-1.12)].ConclusionsIn the CCP subgroup the incidence density of ICH was 5-60 times higher than that observed in elder and general population. The use of bleeding risk score as the HAS-BLED scale could improve the preventive approach of those with higher risk of ICH.Trial registrationThis study was retrospectively registered in ClinicalTrials.gov (NCT03247049) on August 11/2017.
Thematic Areas: Sociologia i política Saúde coletiva Odontología Medicina ii Medicina i Interdisciplinar Gerontology Geriatrics and gerontology Geriatrics & gerontology General o multidisciplinar Engenharias iv Enfermagem Educação física Educação Ciencias sociales Ciências biológicas ii Ciências biológicas i
licence for use: https://creativecommons.org/licenses/by/3.0/es/
Author's mail: blanca.lorman@estudiants.urv.cat paco.martin@urv.cat
Author identifier: 0000-0003-0359-3588
Record's date: 2024-07-27
Papper version: info:eu-repo/semantics/publishedVersion
Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
Papper original source: Bmc Geriatrics. 21 (1):
APA: Lorman-Carbo, Blanca; Lluis Clua-Espuny, Josep; Muria-Subirats, Eulalia; Ballesta-Ors, Juan; Antonia Gonzalez-Henares, Maria; Fernandez-Saez, Jose; Ma (2021). Complex chronic patients as an emergent group with high risk of intracerebral haemorrhage: an observational cohort study. Bmc Geriatrics, 21(1), -. DOI: 10.1186/s12877-021-02004-4
Entity: Universitat Rovira i Virgili
Journal publication year: 2021
Publication Type: Journal Publications
Repositori URV