Effects of platelet infusion, anticoagulant and other risk factors on the rehaemorrhagia after surgery of hypertensive cerebral hemorrhage

T. Chen, G. Xu, D. Tan, C. Wu

Department of  Neurosurgery, Qilu  Hospital of Shandong University, Jinan,  China. drchenteng@hotmail.com

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• Neurology

OBJECTIVE: Our objective is to explore the effect of platelet infusion, anticoagulant and other risk factors on the rehaemorrhagia after surgery of hypertensive cerebral hemorrhage (HCH), and to provide a reference for the prevention and treatment of rehaemorrhagia in patients with HCH.

PATIENTS AND METHODS: The patients with HCH admitted during April, 2007-June, 2012 in our hospital were selected. The general data such as age and gender, disease course, past pathogenic characters, past and present medical history such as treatment, personal history, family history and son on, were collected. The data were analyzed by t test, ANOVA, Chi-squared test and logistic regression analysis.

RESULTS: The application of aspirin and platelets has significant effect on rehaemorrhagia after surgery of HCH: 72 patients received aspirin, of which 14 cases had rehaemorrhagia while 197 patients did not receive aspirin, of which 20 cases had rehaemorrhagia. The difference between these two groups was statistically significant (p < 0.05). 186 patients received platelet infusions, of which 18 cases had rehaemorrhagia whereas among other 83 patients not receiving platelet infusions, 16 cases had rehaemorrhagia. Statistical analysis showed a significant difference between these two groups (p < 0.05). In the univariate logistic regression analysis of related data in patients with rehaemorrhagia after surgery of HCH, diastolic or systolic blood pressure at admission, the time from onset to surgery, coagulation disorder, surgical method, hematoma volume, cerebral hemia, effect of hematoma clearance and GCS at admission were the potential risk factors for rehaemorrhagia after surgery of HCH (p < 0.05). In the multivariate logistic regression analysis of related data in the same patients, diastolic blood pressure at admission (> 120 mmHg), systolic blood pressure at admission (> 200 mmHg), the time from onset to surgery and coagulation disorder were screened out (p < 0.05) to be associated with rehaemorrhagia.

CONCLUSIONS: Aspirin increased the risk of rehaemorrhagia after surgery of HCH. On the contrary, infusion of platelets decreased the risk of rehaemorrhagia and improved the prognosis of patients. High diastolic and/or high systolic blood pressure at admission, ultra-early surgery after onset of HCH and coagulation disorder were related with rehaemorrhagia after operation of HCH. Our results indicate that rehaemorrhagia rate can be decreased by controlling related risk factors.

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