{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T12:27:02Z","timestamp":1781699222934,"version":"3.54.5"},"reference-count":30,"publisher":"BMJ","issue":"7","funder":[{"DOI":"10.13039\/501100002736","name":"Covidien","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002736","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Neurol Neurosurg Psychiatry"],"accepted":{"date-parts":[[2019,2,7]]},"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the occurrence of intracranial haemorrhagic complications (IHC) on heparin prophylaxis (low-dose subcutaneous heparin, LDSH) in primary spontaneous intracerebral haemorrhage (ICH) (not oral anticoagulation-associated ICH, non-OAC-ICH), vitamin K antagonist (VKA)-associated ICH and non-vitamin K antagonist oral anticoagulant (NOAC)-associated ICH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective cohort study (RETRACE) of 22 participating centres and prospective single-centre study with 1702 patients with VKA-associated or NOAC-associated ICH and 1022 patients with non-OAC-ICH with heparin prophylaxis between 2006 and 2015. Outcomes were defined as rates of IHC during hospital stay among patients with non-OAC-ICH, VKA-ICH and NOAC-ICH, mortality and functional outcome at 3 months between patients with ICH with and without IHC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>IHC occurred in 1.7% (42\/2416) of patients with ICH. There were no differences in crude incidence rates among patients with VKA-ICH, NOAC-ICH and non-OAC-ICH (log-rank p=0.645; VKA-ICH: 27\/1406 (1.9%), NOAC-ICH 1\/130 (0.8%), non-OAC-ICH 14\/880 (1.6%); p=0.577). Detailed analysis according to treatment exposure (days with and without LDSH) revealed no differences in incidence rates of IHC per 1000 patient-days (LDSH: 1.43 (1.04\u20131.93) vs non-LDSH: 1.32 (0.33\u20133.58), conditional maximum likelihood incidence rate ratio: 1.09 (0.38\u20134.43); p=0.953). Secondary outcomes showed differences in functional outcome (modified Rankin Scale=4\u20136: IHC: 29\/37 (78.4%) vs non-IHC: 1213\/2048 (59.2%); p=0.019) and mortality (IHC: 14\/37 (37.8%) vs non-IHC: 485\/2048 (23.7%); p=0.045) in disfavour of patients with IHC. Small ICH volume (OR: volume &lt;4.4 mL: 0.18 (0.04\u20130.78); p=0.022) and low National Institutes of Health Stroke Scale (NIHSS) score on admission (OR: NIHSS &lt;4: 0.29 (0.11\u20130.78); p=0.014) were significantly associated with fewer IHC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Heparin administration for venous thromboembolism (VTE) prophylaxis in patients with ICH appears to be safe regarding IHC among non-OAC-ICH, VKA-ICH and NOAC-ICH in this observational cohort analysis. Randomised controlled trials are needed to verify the safety and efficacy of heparin compared with other methods for VTE prevention.<\/jats:p><\/jats:sec>","DOI":"10.1136\/jnnp-2018-319786","type":"journal-article","created":{"date-parts":[[2019,4,16]],"date-time":"2019-04-16T21:35:04Z","timestamp":1555450504000},"page":"783-791","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":29,"title":["Heparin for prophylaxis of venous thromboembolism in intracerebral haemorrhage"],"prefix":"10.1136","volume":"90","clinical-trial-number":[{"clinical-trial-number":"nct01829581","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct03093233","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct03183167","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Maximilian 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