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Lookup NU author(s): Professor Christopher PriceORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2023 The Authors. Introduction: People immobilized following acute spontaneous intracerebral haemorrhage (ICH) are at risk of venous thromboembolism (VTE) but the role of short-term prophylactic anticoagulation remains uncertain. We surveyed UK clinical practice and opinion regarding preventing VTE after ICH. Patients and methods: An online survey was sent to stroke healthcare professionals within the United Kingdom and Ireland via a professional society (British and Irish Association of Stroke Physicians (BIASP)). Results: One hundred and twenty-three staff members responded to the survey, of whom 80% were consultant stroke physicians. All responders except one considered the issue to be important or extremely important, but only 5 (4%) were “extremely certain” and 51 (41%) “fairly certain” regarding the optimal treatment approach. Intermittent pneumatic compression (IPC) devices alone were the most used method (in 60%) followed by IPC devices and switching to low molecular weight heparin (LMWH) (in 30%). We identified high levels of uncertainty regarding the role of anticoagulation, and its optimal timing; uncertainty was greater in lobar compared to deep ICH. Most respondents (93%) consider a randomised controlled trial investigating the role of pharmacological VTE prophylaxis after acute ICH as important and would consider participation. Discussion and conclusion: The optimal method for the prevention of VTE in non-traumatic ICH patients remains an area of clinical uncertainty. Clinical trials assessing short-term anticoagulation in patients after acute ICH would be beneficial in providing evidence to resolve this clinical dilemma.
Author(s): Mendel R, Abdelhameed N, Salman RA-S, Cohen H, Dowlatshahi D, Freemantle N, Paciaroni M, Parry-Jones A, Price C, Sprigg N, Werring DJ
Publication type: Article
Publication status: Published
Journal: Journal of the Neurological Sciences
Year: 2023
Volume: 454
Print publication date: 15/11/2023
Online publication date: 25/10/2023
Acceptance date: 23/10/2023
Date deposited: 09/11/2023
ISSN (print): 0022-510X
ISSN (electronic): 1878-5883
Publisher: Elsevier BV
URL: https://doi.org/10.1016/j.jns.2023.120855
DOI: 10.1016/j.jns.2023.120855
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