Influence of platelet inhibitor drugs in postoperative rebleeding of patients with hypertensive cerebral hemorrhage

Objective To analyze the influence of platelet inhibitor drugs in postoperative rebleeding of patients with hypertensive cerebral hemorrhage (HCH) who underwent hematoma evacuation. Methods A retrospective analysis was conducted on patients of HCH who underwent hematoma evacuation at Neurosurgery Department, General Hospital of Shenyang Military Command from January 2013 to June 2016. Among all cases, 25 had medical history of platelet inhibiting drug use and were assigned to Group A. Group B consisted of the remaining 128 cases without medication history of platelet inhibitors. The rebleeding rate was compared by case-control study between 2 groups. Results No significant difference was found in the gender, age, blood pressure, location of hemorrhage or volume of hematoma between Group A and B (all P>0.05). In group A, postoperative CT demonstrated rebleeding in 2 (8.0%) patients including 1 case of symptomatic hemorrhage and 1 case of asymptomatic hemorrhage who remitted following second operation of hematoma evacuation and conservative therapy, respectively. In Group B, there were 8 (6.3%) patients of rebleeding including 2 asymptomatic cases and 6 symptomatic cases that underwent no further treatment. The postoperative rebleeding rate was not statistically significant between 2 groups (χ2=0.014, P>0.05). Conclusion The rebleeding rate might not be significantly increased in postoperative patients of HCH using platelet inhibiting drugs, which suggests that surgical operation could be indicated for proper selection of those patients. Key words: Intracranial hemorrhage, hypertensive; Aspirin; Root cause analysis; Postoperative rebleeding