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Background <p>Evidence comparing different non–vitamin K antagonist oral anticoagulants (NOACs) in terms of intracranial hemorrhage (ICH) characteristics and clinical outcomes is limited.</p> Aim <p>This study aimed to identify factors associated with mortality and morbidity in geriatric patients receiving different NOACs presenting to the emergency department with intracranial hemorrhage.</p> Methods <p>This multicenter retrospective observational study. Geriatric patients (aged ≥ 65 years) who presented to the emergency department with ICH while receiving NOAC therapy were included. Clinical characteristics were extracted from electronic medical records. The primary outcome was in-hospital mortality, while secondary outcomes included hemorrhage volume, intraventricular hemorrhage, intensive care unit admission, and the effect of four-factor prothrombin complex concentrate administration. Statistical analyses were performed using the chi-square or Fisher’s exact tests for categorical variables and the Mann–Whitney U or t-test for continuous variables, with <i>p</i> &lt; 0.05 considered statistically significant.</p> Results <p>A total of 47 patients were included; 57.4% (<i>n</i> = 27) were female and 42.6% (<i>n</i> = 20) were male. No significant association was observed between NOAC type and in-hospital mortality (<i>p</i> = 0.533). Intraventricular hemorrhage was significantly more frequent in the rivaroxaban group than in the apixaban group (42.9% vs. 9.5%, <i>p</i> = 0.014). Intraventricular hemorrhage (52.6% vs. 4.2%, <i>p</i> &lt; 0.001) and atrial fibrillation (90.5% vs. 57.7%, <i>p</i> = 0.012) were significantly more common in the mortality group compared with the survival group.</p> Conclusion <p>NOAC type was not associated with in-hospital mortality; however, intraventricular hemorrhage occurred more frequently in patients receiving rivaroxaban and was significantly associated with mortality.</p>

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Clinical characteristics and outcomes of intracranial hemorrhage in geriatric patients receiving non–vitamin K antagonist oral anticoagulants: a multicenter observational study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月21日

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  • Ramazan Guven,
  • Akkan Avci,
  • Ozgur Sogut,
  • Serkan Dogan,
  • Mehmet Akif Karamercan,
  • Ertugrul Altinbilek,
  • Semih Korkut,
  • Ertugrul Altug,
  • Begum Seyda Avci,
  • Yunus Dogan,
  • Adem Az,
  • Gokhan Eyupoglu,
  • Said Kural,
  • Ogulcan Alp,
  • Metin Ozmen,
  • Ozgur Guven,
  • Yeliz Simsek,
  • Erdem Aksay,
  • Ahmet Burak Urfalioglu,
  • Pelin Oguz Tura,
  • Hakan Kaan Yilmaz,
  • Sara Tunca,
  • Can Ilcin,
  • Efe Demir Bala,
  • Munisahan Güvercin

摘要

Background

Evidence comparing different non–vitamin K antagonist oral anticoagulants (NOACs) in terms of intracranial hemorrhage (ICH) characteristics and clinical outcomes is limited.

Aim

This study aimed to identify factors associated with mortality and morbidity in geriatric patients receiving different NOACs presenting to the emergency department with intracranial hemorrhage.

Methods

This multicenter retrospective observational study. Geriatric patients (aged ≥ 65 years) who presented to the emergency department with ICH while receiving NOAC therapy were included. Clinical characteristics were extracted from electronic medical records. The primary outcome was in-hospital mortality, while secondary outcomes included hemorrhage volume, intraventricular hemorrhage, intensive care unit admission, and the effect of four-factor prothrombin complex concentrate administration. Statistical analyses were performed using the chi-square or Fisher’s exact tests for categorical variables and the Mann–Whitney U or t-test for continuous variables, with p < 0.05 considered statistically significant.

Results

A total of 47 patients were included; 57.4% (n = 27) were female and 42.6% (n = 20) were male. No significant association was observed between NOAC type and in-hospital mortality (p = 0.533). Intraventricular hemorrhage was significantly more frequent in the rivaroxaban group than in the apixaban group (42.9% vs. 9.5%, p = 0.014). Intraventricular hemorrhage (52.6% vs. 4.2%, p < 0.001) and atrial fibrillation (90.5% vs. 57.7%, p = 0.012) were significantly more common in the mortality group compared with the survival group.

Conclusion

NOAC type was not associated with in-hospital mortality; however, intraventricular hemorrhage occurred more frequently in patients receiving rivaroxaban and was significantly associated with mortality.