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

Guven, Ramazan; Avci, Akkan; SÖĞÜT, Özgür; DOĞAN, Serkan; KARAMERCAN, MEHMET; ALTINBİLEK, Ertuğrul; KORKUT, Semih; ALTUĞ, Ertuğrul; AVCİ, Begüm; Dogan, Yunus; Az, Adem; EYÜPOĞLU, Gökhan; Kural, Said; Alp, Ogulcan; Ozmen, Metin; Guven, Ozgur; Simsek, Yeliz; Aksay, Erdem; Urfalioglu, Ahmet; Tura, Pelin; Yilmaz, Hakan; Tunca, Sara; Ilcin, Can; Bala, Efe; Güvercin, Munisahan

doi:10.1007/s11845-026-04404-0

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

Guven R., Avci A., SÖĞÜT Ö., DOĞAN S., KARAMERCAN M. A., ALTINBİLEK E., ...Daha Fazla

Irish Journal of Medical Science, cilt.195, sa.4, ss.2423-2430, 2026 (SCI-Expanded, Scopus)

Yayın Türü: Makale / Tam Makale
Cilt numarası: 195 Sayı: 4
Basım Tarihi: 2026
Doi Numarası: 10.1007/s11845-026-04404-0
Dergi Adı: Irish Journal of Medical Science
Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
Sayfa Sayıları: ss.2423-2430
Anahtar Kelimeler: NOACs, Intracranial hemorrage, Mortality, Geriatric patients
Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

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.