Studies have shown that intracerebral hemorrhage (ICH) accounts for 10 to 20% of all acute cerebrovascular events, as well as a significant amount of stroke related disability and mortality. Studies have also demonstrated that oral anticoagulation treatment (OAT) is associated with an increased risk of ICH. This study was designed to determine whether the resumption of OAT after an ICH is associated with long-term outcome.

Data were analyzed from three, large studies of intracerebral hemorrhage, including RETRACE, OAT-ICH and ERICH. In all studies, adult patients diagnosed with ICH had been taking OAT at the time of the hemorrhage as a treatment for atrial fibrillation (a-fib). All subjects were followed by phone interviews for up to one year for OAT resumption, mortality, modified Rankin scale scores (mRS) and new stroke events.

Data were analyzed for 1，012 survivors. Anticoagulation was resumed in 178 of 633 of those with non-lobar ICH (28%) and 86 of 379 of those with lobar (23%) ICH. There was no significant association between OAT resumption and early mortality for either non-lobar or lobar ICHs. The resumption of OAT was associated with a decrease in all-cause mortality (P＝0.002), all-cause stroke (P＝0.003), ischemic stroke (P＝0.002) and a good outcome (scores of zero to three) on the mRS (P<0.0001).

This study of patients with intracerebral hemorrhage, each taking oral anticoagulants for atrial fibrillation, found that the resumption of oral anticoagulants was associated with decreased mortality and improved functional outcome.