Background: Intracerebral hemorrhage (ICH) is the most serious adverse effect of treatment with oral anticoagulants. Prognostic data after ICH associated with novel oral anticoagulants (NOAC) compared to vitamin-K antagonists (VKA) are sparse. We compared 90-day survival outcome following NOAC-ICH versus VKA-ICH using data from the Swedish Stroke Register (Riksstroke). 
Methods: Using data from Riksstroke and the Swedish Causes of Death Register between 2012 and 2016, we compared all-cause 90-day mortality for patients with NOAC-ICH versus VKA-ICH using Kaplan-Meier survival analysis and Log-rank test. Cox regression, with adjustment for age, sex, previous stroke and level of consciousness (LOC) on admission, was used to estimate hazard ratios (HR) for 90-day mortality. 

Results: We included 2483 patients; 300 with NOAC-ICH and 2183 with VKA-ICH. In both groups, mean age was 79 years, and 58% were male. No significant difference between NOAC-ICH and VKA-ICH was found for all-cause 90-day mortality (44.3% NOAC-ICH versus 42.6% VKA-ICH; p=0.54, HR=0.93; 95% confidence interval (CI): 0.776–1.123). Factors predicting death were increased age (HR=1.027; 95%CI: 1.017–1.037), previous stroke (HR=1.21; 95%CI: 1.06-1.38), and reduced LOC (drowsy: HR=3.48; 95%CI: 2.86–4.23; comatose: HR=12.27; 95%CI: 10.13–14.87).
Conclusion: In the largest study to date on anticoagulant-associated ICH, we found no significant difference in mortality outcome at 90 days between NOAC-ICH versus VKA-ICH.

MORTALITY RATES FOR NOAC VERSUS VKA ASSOCIATED INTRACEREBRAL HEMORRHAGE: A SWEDISH STROKE REGISTER STUDY