The study of Rosand et al1 provides important data about the prognostic impact of oral anticoagulant treatment (OAT) in patients with primary supratentorial intracerebral hemorrhage (ICH). Nevertheless, we are concerned that 2 aspects are not sufficiently discussed by the authors.
First, Rosand et al1 do not provide data on hematoma volume and level of consciousness on admission. It is well established that both factors are strong predictors of intrahospital mortality in patients with ICH.2- 4 For the interpretation of the prognostic effect of OAT in patients with ICH, it is important to differentiate whether patients receiving OAT enter the hospital in poorer condition compared with patients not receiving OAT or whether they deteriorate faster during intrahospital treatment. Furthermore, this has consequences for the early management of patients with ICH receiving OAT.
Thiem U, Friedrich C, Deutschinoff G, Pientka L. The Prognostic Impact of Oral Anticoagulant Treatment in Patients With Intracerebral Hemorrhage. Arch Intern Med. 2004;164(22):2500-2509. doi:10.1001/archinte.164.22.2504-b