BACKGROUND: To assess possible changes in epidemiology, characteristics and outcome of intracranial hemorrhage associated with vitamin K antagonists (ICH-VKA).

METHODS: We evaluate patients with ICH-VKA included in TAC-Registry1(TR1) and TAC-Registry2(TR2) studies. Country-wide, retrospective, observational multicentric studies that included all adult patients with ICH associated with anticoagulation admitted to Neurology Departments. TR1: September 2012-August 2013, TR 2: year 2015.

RESULTS: TR1: 21 hospitals, population area: 8,155,628 inhabitants, N = 235, annual incidence ICH-VKA: 2.88 / 100,000. TR2: 29 hospitals, population area: 11,864,971 inhabitants, N = 331, annual incidence ICH-VKA: 2.79 / 100,000. Both groups had similar baseline characteristics. ICH-VKA represented in TR1 1.14% of Neurology admitted patients, 1.94% of all strokes and 13.62% of ICH; in TR2 1.22%, 2.04% and 16.42% respectively. Average INR at admission: 2.84 (SD: 1.4) in TR1 and 2.75 (DS 1.1) in TR2 (p = NS). Only 37.6% in TR1 and 39.8% in TR2 presented INR in range at admission. Most frequent location: deep regions: 37.4% TR1, 46.2% TR2(p <0.05). In TR1 there were more hemispheric hemorrhages (17% vs 5.4% p 0.001), in TR2 more intraventricular hemorrhages (17.4% vs24.5%, p <0.05). The average mRs3m was similar (p = NS): TR1 4.12 (SD: 2.07), TR2 4.04 (DS 2.12), 24% were independent at 3 months in both groups and 3 months mortality represented 42.6% and 38.7 % respectively (p = NS).

CONCLUSIONS: ICH-VKA incidence remains stable in recent years. Nevertheless, its relative frequency among ICHs has increased. Its poor outcome and association with variable INR ranges remains constant, representing a problem still unsolved.

TEMPORAL EVOLUTION OF INTRACRANIAL HEMORRHAGE ASSOCIATED WITH VITAMIN K ANTAGONISTS IN SPAIN: FROM TAC RESGISTRY 1 TO TAC REGISTRY 2