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Marie Louise Overgaard Svendsen

Preadmission oral anticoagulant treatment and clinical outcome among patients hospitalized with acute stroke and atrial fibrillation: a nationwide study

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Preadmission oral anticoagulant treatment and clinical outcome among patients hospitalized with acute stroke and atrial fibrillation : a nationwide study. / Johnsen, Søren Paaske; Svendsen, Marie Louise; Hansen, Morten Lock; Brandes, Axel; Mehnert, Frank; Husted, Steen Elkjær.

I: Stroke; a journal of cerebral circulation, Bind 45, Nr. 1, 2014, s. 168-75.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

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Johnsen, Søren Paaske ; Svendsen, Marie Louise ; Hansen, Morten Lock ; Brandes, Axel ; Mehnert, Frank ; Husted, Steen Elkjær. / Preadmission oral anticoagulant treatment and clinical outcome among patients hospitalized with acute stroke and atrial fibrillation : a nationwide study. I: Stroke; a journal of cerebral circulation. 2014 ; Bind 45, Nr. 1. s. 168-75.

Bibtex

@article{26c25322baa14d8a810f8eac96dbf855,
title = "Preadmission oral anticoagulant treatment and clinical outcome among patients hospitalized with acute stroke and atrial fibrillation: a nationwide study",
abstract = "BACKGROUND AND PURPOSE: Preadmission oral anticoagulant treatment (OAT) has been linked with less severe stroke and a better outcome in patients with atrial fibrillation. However, the existing studies have methodological limitations and have, with one exception, not included hemorrhagic strokes. We performed a nationwide historic follow-up study using data from population-based healthcare registries to assess the effect of preadmission OAT on stroke outcomes further.METHODS: We identified 11 356 patients with atrial fibrillation admitted to hospital with acute stroke (including ischemic stroke and intracerebral hemorrhage) between 2003 and 2009. Propensity score-matched analyses were used to compare stroke severity (Scandinavian Stroke Scale score) and mortality among 2175 patients with preadmission OAT and 2175 patients without preadmission OAT.RESULTS: A total of 2492 (21.9{\%}) patients received OAT at the time of their stroke. Preadmission OAT was associated with a lower risk of severe stroke (Scandinavian Stroke Scale score at time of admission, <30 point; propensity score-matched odds ratio, 0.74; 95{\%} confidence interval, 0.63-0.86) and lower 30-day mortality rate (propensity score-matched adjusted odds ratio, 0.83; 95{\%} confidence interval, 0.71-0.98).CONCLUSIONS: Only a minority of hospitalized patients with acute stroke with atrial fibrillation received OAT at the time of stroke. Preadmission OAT was associated with less severe stroke and lower 30-day mortality rate in a propensity score-matched analysis.",
keywords = "Aged, Aged, 80 and over, Anticoagulants, Atrial Fibrillation, Denmark, Educational Status, Emergency Medical Services, Female, Follow-Up Studies, Hospitalization, Humans, Length of Stay, Male, Middle Aged, Phenprocoumon, Population, Risk Factors, Stroke, Treatment Outcome, Warfarin",
author = "Johnsen, {S{\o}ren Paaske} and Svendsen, {Marie Louise} and Hansen, {Morten Lock} and Axel Brandes and Frank Mehnert and Husted, {Steen Elkj{\ae}r}",
year = "2014",
doi = "10.1161/STROKEAHA.113.001792",
language = "English",
volume = "45",
pages = "168--75",
journal = "Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams & Wilkins",
number = "1",

}

RIS

TY - JOUR

T1 - Preadmission oral anticoagulant treatment and clinical outcome among patients hospitalized with acute stroke and atrial fibrillation

T2 - a nationwide study

AU - Johnsen, Søren Paaske

AU - Svendsen, Marie Louise

AU - Hansen, Morten Lock

AU - Brandes, Axel

AU - Mehnert, Frank

AU - Husted, Steen Elkjær

PY - 2014

Y1 - 2014

N2 - BACKGROUND AND PURPOSE: Preadmission oral anticoagulant treatment (OAT) has been linked with less severe stroke and a better outcome in patients with atrial fibrillation. However, the existing studies have methodological limitations and have, with one exception, not included hemorrhagic strokes. We performed a nationwide historic follow-up study using data from population-based healthcare registries to assess the effect of preadmission OAT on stroke outcomes further.METHODS: We identified 11 356 patients with atrial fibrillation admitted to hospital with acute stroke (including ischemic stroke and intracerebral hemorrhage) between 2003 and 2009. Propensity score-matched analyses were used to compare stroke severity (Scandinavian Stroke Scale score) and mortality among 2175 patients with preadmission OAT and 2175 patients without preadmission OAT.RESULTS: A total of 2492 (21.9%) patients received OAT at the time of their stroke. Preadmission OAT was associated with a lower risk of severe stroke (Scandinavian Stroke Scale score at time of admission, <30 point; propensity score-matched odds ratio, 0.74; 95% confidence interval, 0.63-0.86) and lower 30-day mortality rate (propensity score-matched adjusted odds ratio, 0.83; 95% confidence interval, 0.71-0.98).CONCLUSIONS: Only a minority of hospitalized patients with acute stroke with atrial fibrillation received OAT at the time of stroke. Preadmission OAT was associated with less severe stroke and lower 30-day mortality rate in a propensity score-matched analysis.

AB - BACKGROUND AND PURPOSE: Preadmission oral anticoagulant treatment (OAT) has been linked with less severe stroke and a better outcome in patients with atrial fibrillation. However, the existing studies have methodological limitations and have, with one exception, not included hemorrhagic strokes. We performed a nationwide historic follow-up study using data from population-based healthcare registries to assess the effect of preadmission OAT on stroke outcomes further.METHODS: We identified 11 356 patients with atrial fibrillation admitted to hospital with acute stroke (including ischemic stroke and intracerebral hemorrhage) between 2003 and 2009. Propensity score-matched analyses were used to compare stroke severity (Scandinavian Stroke Scale score) and mortality among 2175 patients with preadmission OAT and 2175 patients without preadmission OAT.RESULTS: A total of 2492 (21.9%) patients received OAT at the time of their stroke. Preadmission OAT was associated with a lower risk of severe stroke (Scandinavian Stroke Scale score at time of admission, <30 point; propensity score-matched odds ratio, 0.74; 95% confidence interval, 0.63-0.86) and lower 30-day mortality rate (propensity score-matched adjusted odds ratio, 0.83; 95% confidence interval, 0.71-0.98).CONCLUSIONS: Only a minority of hospitalized patients with acute stroke with atrial fibrillation received OAT at the time of stroke. Preadmission OAT was associated with less severe stroke and lower 30-day mortality rate in a propensity score-matched analysis.

KW - Aged

KW - Aged, 80 and over

KW - Anticoagulants

KW - Atrial Fibrillation

KW - Denmark

KW - Educational Status

KW - Emergency Medical Services

KW - Female

KW - Follow-Up Studies

KW - Hospitalization

KW - Humans

KW - Length of Stay

KW - Male

KW - Middle Aged

KW - Phenprocoumon

KW - Population

KW - Risk Factors

KW - Stroke

KW - Treatment Outcome

KW - Warfarin

U2 - 10.1161/STROKEAHA.113.001792

DO - 10.1161/STROKEAHA.113.001792

M3 - Journal article

VL - 45

SP - 168

EP - 175

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 1

ER -