Predictors of Outcome in Warfarin-Related Intracerebral Hemorrhage

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Abstract
Warfarin sodium therapy is frequently used in patients with atrial fibrillation, artificial heart valves, or deep vein thrombosis to prevent thromboembolic complications. Warfarin-associated intracerebral hemorrhage (ICH) is the most feared complication of anticoagulation therapy1 and is becoming more common with increased use of this medication in the aging population.2 Patients with warfarin-associated ICH account for nearly one-fourth of all admissions for ICH in large hospitals.3 The reported incidence of ICH in patients receiving anticoagulant therapy is 7- to 10-fold higher than in the patients not receiving warfarin therapy.4,5 Overall, the risk of warfarin-associated ICH may reach 1% to 2% per year, and the risk increases to 4.2% in patients older than 75 years.6,7 Warfarin use increases the risk of death from ICH, and the intensity of anticoagulation therapy is independently predictive of 3-month mortality.5 The incidence of warfarin-associated ICH is rapidly increasing,8 and the effect of this complication on public health is predicted to continue to grow at an accelerated pace in the near future.