Totally, 1548 adult patients were diagnosed with ICH between January 1, 2015 and July 31, 2019 in Beijing Tiantan Hospital, Capital Medical University; 354 patients were excluded due to a diagnosis of aneurysm, arteriovenous malformation, or moyamoya disease etc.; 883 patients were excluded because they were not severe ICH; 43 patients were excluded because the time from the onset of ICH to their first CT scan was more than 24 hours; 27 patients were excluded because they took other antiplatelet or drugs (such as, vitamin K antagonist (Warfarin), clopidogrel) in 7 days; 9 patients were excluded because they were accompanied by coagulopathy, liver or kidney dysfunction; 11 patients were excluded duo to missing data. Finally, 221sever ICH patients were consecutively enrolled into this study.
ASA Prevalence and Characteristics
There were 50 females and 171 males in this study. Among the study population, there were 72 (32.58%) patients taking ASA within 7 days before sever ICH onset. According to ASA usage, the study population were divided into the ASA group and the nASA group. Their baseline characteristics were summarized in table 1. Compared with nASA group, patients in ASA group were older and more likely to develop diabetes, coronary heart disease, ischemic stroke, and cerebral hemorrhage. There was no significant statistical difference in other variables between nASA group and ASA group.
Association between prior ASA and HV, HG
The results of analysis patients' admission CT showed baseline HV (45.51±29.76) of severe ICH patients in nASA group was significantly higher than that (32.67±25.85) of ASA group (p = 0.001), as shown in table 2. However, after adjusting for factors of age, diabetes, coronary heart disease, ischemic stroke, cerebral hemorrhage and hydrocephalus, the impact of ASA on baseline HV did not reach statistical differences (p =0.057, 95% confidence interval (CI), -10.042 (-20.376, 0.292)), as shown in table 3.
Table 2 showed although the statistical difference was not reached, the ratio (54/149, 36.2%) of HG in nASA group was higher than that (18/72, 25.0%) in ASA group. Similarly, after adjusting for factors of age, diabetes, coronary heart disease, ischemic stroke, cerebral hemorrhage and hydrocephalus, ASA did not significantly affect HG of sever ICH patients (p =0.057, 95% CI, -10.042 (-20.376, 0.292)), as shown in table 3.
Risk Factors of HG
The study population were divided into HG group and nHG group according to the change of HV; their characteristics were summarized in table 4. In univariate analysis, HG were significantly correlated with admission high blood pressure, hydrocephalus, HV and GCS (p＜0.05), as shown in table 4.
To screen risk factors of HG, variables with p＜0.1 in univariate analysis (shown in table 4) were included into multivariate analysis. After adjusting for factors of admission high blood pressure, coronary heart disease, ASA, hydrocephalus, HV and GCS, the predictive indicators of HG were admission high blood pressure and GCS, as shown in table 5.