Clinical presentation, course, and management of anticoagulation-associated ICH
| Case . | Cancer type . | AC type* . | ICH class† . | ICH presentation‡ . | ICH course‡ . | PCC . | Surgical management . | ICU . | AC management§ . | Death|| . |
|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Lung | Apixaban | Measurable | 1 | 1 | No | No | No | Continue | No |
| 2 | Lung | Apixaban | Major | 3 | 3 | Yes | No | Yes | Stop | No |
| 3 | RCC | Apixaban | Measurable | 1 | 1 | No | No | No | Continue | No |
| 4 | RCC | Rivaroxaban | Major | 3 | 3 | Yes | No | Yes | Stop | No |
| 5 | Lung | Nadroparin | Major | 3 | 1 | No | No | No | Stop | Yes (+62) |
| 6 | Lung | Enoxaparin | Trace | 1 | 1 | No | No | No | Continue | No |
| 7¶ | Lung | Enoxaparin | Major | 3 | 2 | No | Yes | No | Hold (9 d) | No |
| 8 | Lung | Enoxaparin | Major | 3 | — | — | — | — | — | Yes (+14) |
| 9 | Thymic NEC | Enoxaparin | Major | 3 | 1 | No | No | No | Hold (2 d) | Yes (+21) |
| 10¶ | Lung | Enoxaparin | Major | 3 | — | — | — | — | — | Yes (+32) |
| Case . | Cancer type . | AC type* . | ICH class† . | ICH presentation‡ . | ICH course‡ . | PCC . | Surgical management . | ICU . | AC management§ . | Death|| . |
|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Lung | Apixaban | Measurable | 1 | 1 | No | No | No | Continue | No |
| 2 | Lung | Apixaban | Major | 3 | 3 | Yes | No | Yes | Stop | No |
| 3 | RCC | Apixaban | Measurable | 1 | 1 | No | No | No | Continue | No |
| 4 | RCC | Rivaroxaban | Major | 3 | 3 | Yes | No | Yes | Stop | No |
| 5 | Lung | Nadroparin | Major | 3 | 1 | No | No | No | Stop | Yes (+62) |
| 6 | Lung | Enoxaparin | Trace | 1 | 1 | No | No | No | Continue | No |
| 7¶ | Lung | Enoxaparin | Major | 3 | 2 | No | Yes | No | Hold (9 d) | No |
| 8 | Lung | Enoxaparin | Major | 3 | — | — | — | — | — | Yes (+14) |
| 9 | Thymic NEC | Enoxaparin | Major | 3 | 1 | No | No | No | Hold (2 d) | Yes (+21) |
| 10¶ | Lung | Enoxaparin | Major | 3 | — | — | — | — | — | Yes (+32) |
AC, anticoagulation; ICU, intensive care unit; NEC, neuroendocrine carcinoma; PCC, prothrombin complex concentrate; RCC, renal cell carcinoma.
The anticoagulation dose at the time of ICH was therapeutic in 9 out of 10 cases (prophylactic in case 8), and no patients were receiving antiplatelet therapy.
Major indicates ICH ≥10 mL in volume, required surgical intervention, or was associated with symptoms; Measurable indicates ICH volume ≥1 mL but <10 mL; trace indicates ICH volume <1 mL or unmeasurable.
Based on prespecified criteria as shown in supplemental Table 1, as reported by Bleker et al.18
Anticoagulation management at ICH. The number in parentheses indicates the number of days until anticoagulation was resumed after temporarily holding.
Death by 90 days post-ICH. The number in parentheses indicates the number of days between ICH and death.
Incomplete follow-up data post-ICH.