Impact of Desmopressin on Clinical Outcomes in Patients with Spontaneous Antiplatelet-Associated Intracerebral Hemorrhage Undergoing Neurosurgical Intervention: An Observational Multi-Center Study

Impact of Desmopressin on Clinical Outcomes in Patients with Spontaneous Antiplatelet-Associated Intracerebral Hemorrhage Undergoing Neurosurgical Intervention: An Observational Multi-Center Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Impact of Desmopressin on Clinical Outcomes in Patients with Spontaneous Antiplatelet-Associated Intracerebral Hemorrhage Undergoing Neurosurgical Intervention: An Observational Multi-Center Study Pang-Ting Hsu, Chien Shuo-Chi, Ching-Chang Chen, Zhuo-Hao Liu, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4440555/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective: Managing surgical cases of acute spontaneous intracerebral hemorrhage (ICH) in patients with antiplatelet therapy presents significant challenges due to the heightened risk of bleeding. Desmopressin acetate (DDAVP) is commonly employed as a management strategy. This multi-center study aims to compare the functional and safety outcomes in patients with or without preoperative DDAVP administration after spontaneous antiplatelet-associated ICH. Methods: From January 2016 to November 2023, we enrolled patients with spontaneous ICH who were under antiplatelet therapy and needed neurosurgical interventions in the emergency departments. Patients were excluded for traumatic brain injury, ICH from subarachnoid hemorrhage, arteriovenous malformation, intracranial tumors, coagulopathies, and anticoagulant use. The primary outcome was the modified Rankin Scale (mRS) at discharge. Secondary endpoints included safety outcomes, in-hospital and follow-up outcomes. Results: A total of 75 patients were included, comprising 26 patients treated with DDAVP and 49 patients in the control group. After inverse probability of treatment weighting adjustment, there were no significant differences in baseline characteristics except for preoperative platelet transfusion between the DDAVP and control group (73.6% vs 33.6%; p = 0.007). There were no significant differences in mRS of 4 – 6 at discharge between groups (77.4% vs 85.1%; p = 0.533). Multivariable generalized estimating equations logistic regression demonstrated DDAVP was not significantly associated with improved functional outcome, safety outcomes, in-hospital or follow-up outcomes. Conclusion: This study demonstrated that there was no significant difference in mRS at discharge or SAEs between patients with and without DDAVP administration. Further randomized controlled trials are warranted to validate our findings. Intracranial Hemorrhages (ICH) Desmopressin acetate (DDAVP) Antiplatelet Agent Neurosurgery Treatment Outcome Figures Figure 1 Figure 2 Figure 3 Introduction Acute spontaneous intracerebral hemorrhage (ICH) poses a significant medical challenge, often resulting in severe morbidity and, in some cases, mortality. Accounting for approximately 10% of cerebral vascular accidents, spontaneous ICH warrants attention due to its potentially life-threatening implications 1,2 . The situation becomes more intricate when patients previously under antiplatelet or anticoagulant regimens encounter hemorrhagic emergencies, particularly when surgical intervention is on the horizon. While prompt cessation of medication and immediate reversal are recommended for those on anticoagulants, the appropriate management for antiplatelet-associated situations remains a subject of debate 3–6 . Desmopressin (1-deamino-8-D-arginine vasopressin; DDAVP), known for its efficacy in treating bleeding in patients with platelet dysfunction or those on antiplatelet agents, has been investigated for its potential to limit hematoma expansion in antiplatelet-associated ICH patients 7–9 . However, to date, there exists a void in the literature regarding the use of DDAVP in the context of neurosurgery for spontaneous ICH patients who were previously on antiplatelet therapy. This multi-center, real-world study aims to fill this knowledge gap by providing a comprehensive evaluation of the efficacy and safety of DDAVP therapy in spontaneous ICH patients with a history of antiplatelet use and a concurrent need for neurosurgical intervention. Methods Study Design and Setting This multi-center observational study was conducted using data from the emergency departments (EDs) of two medical centers and one regional hospital in Taiwan, all of which utilized a shared electronic medical records system (EMRs). Collectively, these hospitals have more than 7,000 beds and annually accommodate approximately 350,000 emergency department visits. The study included all adult patients who fulfilled the inclusion criteria from January 1, 2016, to November 30, 2023. The institutional review board (IRB) of the Chang Gung Medical Foundation reviewed and approved on January 29, 2024 (IRB no. 202302212B0C601), ensuring compliance with the Declaration of Helsinki. The IRB waived the need for informed consent, adhering to the STROBE guideline. Patient Selection and Data Collection By conducting a computerized search of the EMRs within the study timeframe, we identified all adult patients who presented with spontaneous ICH in the EDs based on International Classification of Diseases (ICD)-10 codes from I61.0 to I61.9. Patients were included if they were reportedly taking antiplatelet therapy for at least one week prior to admission and diagnosed with a new spontaneous ICH who underwent subsequent neurosurgical intervention (i.e., surgical evacuation or external ventricular drain (EVD)). The determination of patients taking antiplatelet medications is based on EMR documentation. In our institutions, emergency physicians conduct computed tomography (CT) scans of the brain for patients suspected of cerebrovascular accidents. Consultation with neurosurgeons and neurologists is standard practice upon the diagnosis of spontaneous ICH on brain CT. Following the guidelines for managing spontaneous ICH, craniotomy for surgical evacuation of the hematoma is recommended for patients with lobar clots exceeding 30 ml and located within 1 cm of the brain surface. In cases of cerebellar ICH, surgical evacuation is indicated for hematomas larger than 3 cm in diameter, those causing brainstem compression, or presenting with hydrocephalus. Conversely, for patients with thalamic hemorrhage that has ruptured into the ventricle, EVD is the recommended course of action 1,10–12 . The treatment plan is formulated through collaborative discussions involving neurosurgeons, neurologists, and emergency physicians. Shared decision-making with the patient and their family is integral, especially in cases of acute spontaneous ICH associated with antiplatelet therapy. The multidisciplinary team decision also extends to preoperative interventions such as blood transfusion of platelet concentrate (a single transfusion of 12 to 24 units) and/or the administration of desmopressin (DDAVP) (a single dose of 0.4 µg/kg IV). Patients were excluded if they had traumatic brain injury, were diagnosed with ICH due to subarachnoid hemorrhage (SAH), arteriovenous malformation, or an intracranial tumor, or had coagulopathies including concomitant treatment with anticoagulant medications, acquired or inherent coagulopathic disease, international normalized ratio (INR) > 1.5, or platelet count < 100,000/uL within 24 h of ICH. Eligible patients were then stratified into two groups, with those who received DDAVP before surgical intervention and those who did not. The records of the patients selected with EMRs were manually reviewed by two physicians for the verification of their inclusion eligibility (P.-T. H. and S.-C. C.). Patient characteristics collected included demographics, hospital institution, clinical course, presenting blood pressure, relevant past medical history, antiplatelet medications, initial Glasgow Coma Scale (GCS) score and ICH score within 24 h of ICH diagnosis. We collected laboratory data during the initial presentation, including serum hemoglobin levels, platelet count, INR, and sodium levels. Follow-up post-operative sodium levels within 48 hours were also obtained. Preoperative medication with tranexamic acid, platelet transfusion and DDAVP dose were documented. Surgical records including operation time, intraoperative bleeding volume, and blood transfusion volume were collected. CT scans were utilized for brain imaging analyses. Independent assessments of ICH volume, location, the presence of intraventricular hemorrhage (IVH) and hydrocephalus were conducted by a neuroradiologist (Y.-C. T.) and a neurosurgeon (Z.-H. L.). These evaluations, which both raters performed while blinded to baseline characteristics, treatment, and clinical outcomes, ensured an unbiased approach. The primary outcome was the functional outcome at discharge, scored with the modified Rankin Scale (mRS) 13–15 . Secondary endpoints included safety outcomes for serious adverse events (SAEs) during hospitalization (including rebleeding, neurologic deterioration, newly developed brain herniation, intraventricular hematoma extension or hydrocephalus, thromboembolism, hyponatremia, infection with pneumonia and urinary tract infection, epileptic seizure, and adverse transfusion reactions), in-hospital and follow-up outcomes (including in-hospital mortality, length of hospital stays, and readmission to neurosurgical wards within 30 days). Occurrence of thromboembolism, including deep vein thrombosis, acute ischemic stroke, myocardial infarction, and pulmonary embolism, was evaluated within 7 days of admission. These were confirmed by diagnostic test results (including doppler ultrasound, brain CT scan, or additional neurological imagining) during hospitalization. Neurologic deterioration was defined according to any of the following criteria: (1) deterioration of Glasgow Coma Scale (GCS) score, (2) diminished muscle strength in the extremities, (3) occurrence of seizure attacks, (4) persistence or prolongation of symptoms such as headache, dizziness, or vomiting, and (5) signs of increased intracranial pressure, including hypertension, bradycardia, and irregular breathing patterns 16,17 . Rebleeding was defined as neurologic deterioration in conjunction with increased hemorrhage burden on a repeated brain CT. Hyponatremia was defined as serum sodium < 135 mEq/L within 48 hours of admission after the operation. Statistical Analysis We calculated descriptive statistics as numbers and percentages for categorical data, while parametric and non-parametric continuous variables were reported as mean ± standard deviations (SD) or median [interquartile ranges] (IQR), respectively. Normality of data distribution was determined by the Shapiro-Wilks test and histogram visualization. Categorical variables were compared using Pearson's chi-square or Fisher's exact test, while continuous variables were compared using the independent Student's t-test for normally distributed data, or the Wilcoxon rank-sum test for non-normally distributed data, as appropriate. To generate more homogeneous comparisons between the DDAVP and the control group, we used propensity scores with inverse probability of treatment weighting (IPTW) for the main and subgroup analyses. We adopted IPTW adjustment in this study because it could provide average treatment effects in the whole study population that mimic the target inference from randomized clinical trials. Propensity scores were calculated with a binary logistic regression for receiving DDAVP using the following baseline characteristics as the independent variables: age, gender, BMI, presenting blood pressure, GCS score, past medical history, prior type of antiplatelet therapy, preoperative platelet transfusion, preoperative tranexamic acid treatment, laboratory data, operative method, and ICH location, etiology, volume, and score, as listed in Table 1. Between-group differences were assessed using the absolute standardized mean differences obtained from the two pairwise comparisons of DDAVP and control groups, with a cutoff value < 0.1 being considered well balanced. To assess the association between DDAVP administration and clinical outcomes, we employed a multivariable generalized estimating equation (GEE) logistic regression model with an exchangeable correlation structure. We used cluster-robust standard errors, with individual hospitals serving as clusters within the IPTW cohort. The multivariable model was adjusted for each covariate that continued to exhibit a standardized difference greater than 0.1 after balancing between the two groups. We planned to perform four prespecified subgroup analyses to evaluate treatment-by-covariate interactions to explore the heterogeneity of the treatment effects across different covariates, including operative method (surgical evacuation vs EVD only), type of antiplatelet therapy regimen (single vs dual), preoperative platelet transfusion (yes vs no), and ICH volume (> 30 ml vs \(\le\) 30ml). The results of each model were summarized using odds ratios (ORs) and their corresponding 95% confidence intervals (CIs). All reported p values were two-sided, and we considered p values less than 0.05 as statistically significant. These analyses were conducted using R version 4.1.2 (R Foundation for Statistical Computing, Vienna, Austria). Results Baseline characteristics A total of 75 patients were studied, comprising 26 patients treated with DDAVP and 49 patients in the control group (Fig. 1 ). After IPTW adjustments, there were no significant differences in baseline characteristics, including age, gender, body mass index (BMI), systolic blood pressure, GCS score, past medical history, prior antiplatelet therapy, preoperative tranexamic acid use, laboratory data, ICH location, ICH etiology, ICH volume, ICH score, and operative method (Table 1). However, preoperative platelet transfusion remained significantly different between the two groups (73.6% vs 33.6%; p = 0.007). Perioperative records and outcome measures Table 2 presents the perioperative records and outcome measures for both the DDAVP and control groups. Following IPTW adjustment, no significant differences were observed in the intraoperative bleeding volume, blood transfusion volume, and operation time between the two groups. In the secondary analysis, where perioperative records were grouped by operative method (i.e., surgical evacuation or EVD only), no significant differences were found between the DDAVP and control groups. For the primary outcome, there were no significant differences in mRS of 4–6 at discharge between groups (77.4% vs 85.1%; p = 0.533) after IPTW adjustment. SAEs occurred in 66 patients (88%). Safety outcomes did not differ significantly between groups before and after IPTW adjustment. Regarding in-hospital and follow-up outcomes, there were no significant differences in length of hospital stay, length of ICU stay, in-hospital mortality, and readmission to neurosurgical wards within 30 days before and after IPTW adjustment. Multivariable analyses and subgroup analyses for the outcomes We performed multivariable GEE logistic regression with adjustment for each unbalanced covariate from baseline characteristics after IPTW (Table 1). The model demonstrated that DDAVP was not significantly associated with improved functional outcome, safety outcomes, in-hospital, or follow-up outcomes (Fig. 2 ). In the prespecified subgroup analyses, operative method, preoperative platelet transfusion, and ICH volume had no significant interaction with the effect of the DDAVP versus control group (Fig. 3 ). Type of antiplatelet therapy was not performed for subgroup analysis since there were only four patients receiving dual antiplatelet therapy. Discussion Our study presents a novel examination of the role of DDAVP in the management of patients with spontaneous antiplatelet-associated ICH undergoing neurosurgical interventions. The findings indicate that DDAVP administration does not significantly influence the functional outcome, nor does it appear to increase the SAEs or reduce the risk of mortality among this patient population. This observation was consistent across predefined subgroups and remained even after adjustments for unbalanced covariates from baseline characteristics after IPTW. To the best of our knowledge, this study is the first to assess the impact of DDAVP on clinical outcomes in patients with antiplatelet-associated ICH necessitating neurosurgical interventions. Several observational studies have explored the effects of ICH in patients on antiplatelet therapy, focusing primarily on outcomes related to hematoma expansion and, in fewer instances, neurologic function. The findings from these studies have been mixed. Feldman et al. identified an association between DDAVP use and a reduced risk of hematoma expansion, defined as an increase of 3 mL or more, in patients with spontaneous ICH (DDAVP, 10.9% vs no DDAVP, 36.2%; p = 0.002) 18 . Similarly, Barletta et al. found that DDAVP administration in patients with traumatic brain injuries or spontaneous ICH was correlated with a lower incidence of hematoma expansion (DDAVP, 14% vs no DDAVP, 30%; p = 0.015) 19 . Conversely, Summers et al. observed a comparable frequency of hematoma expansion, defined as a > 20% increase from baseline, between DDAVP and non-DDAVP groups (16.1% vs 17.6%; p = 0.78) 9 . McManus et al. reported similar rates of hematoma expansion, either > 33% or a 12.5 mL increase from baseline (DDAVP, 11.8% vs no DDAVP, 11.1%; p = 0.99) 8 . Schmidt et al. included patients with spontaneous ICH and noted no significant changes in hematoma size, defined as a ≥ 6 mL increase from baseline (DDAVP, 30% vs no DDAVP, 28%; p = 0.82) 20 . Mengel et al. evaluated the combined impact of DDAVP and platelet transfusion in spontaneous ICH patients, finding no significant reduction in hematoma expansion, defined as ≥ 33% increase from baseline (DDAVP, 22% vs no DDAVP, 22%; p = 0.98) 7 . In terms of functional outcomes, Mengel et al. observed that patients not receiving DDAVP and platelet transfusion exhibited better three-month functional outcome (mRS ≤ 3; DDAVP, 31.9% vs no DDAVP, 51.5%; p = 0.024) 7 . Feldman et al. saw no significant differences in discharge mRS between the groups (DDAVP, 4 vs no DDAVP, 4; p = 0.483) 18 . A limited number of studies have examined the effect of DDAVP on patients undergoing non-cardiac surgery. In the context of neurosurgical interventions, only a single study by Francoeur et al. assessed outcomes in 1,639 SAH patients undergoing angiography and either surgical or endovascular treatment, with and without DDAVP 21 . Of these, 143 (9%) received DDAVP upon admission. The findings suggested DDAVP was associated with a 45% reduction in the risk of rebleeding, regardless of previous antiplatelet medication use (DDAVP, 4% vs. no DDAVP, 9%, adjusted OR 0.55, 95% CI 0.27–0.97), and a 47% improvement in the odds of a favorable neurological outcome (OR, 1.47; 95% CI, 1.06–2.03). In contrast, our study indicated that DDAVP was not significantly associated with decreased rebleeding rates or improved functional outcomes, diverging from Francoeur et al.'s findings. Several factors may account for these discrepancies. First, our research focused on patients with spontaneous ICH, a condition distinct from the SAH cases Francoeur et al. examined. Second, in their study, patients treated with antiplatelet therapy constituted a minor proportion of 12%, though they adjusted for this variable in their outcomes. Third, we defined functional outcome as the mRS at discharge, whereas Francoeur et al. assessed mRS in survivors at three months, a methodological difference that could introduce survivorship bias. It is important to highlight that our study observed a significantly higher rate of platelet transfusion in the DDAVP group compared to the control group (69.2% vs 30.6%, p = 0.003). The PATCH trial indicated that for patients with spontaneous ICH not undergoing surgery, platelet transfusion did not reduce hematoma expansion, death, or dependence 22 . Instead, it was associated with a marginally increased risk of SAEs. Conversely, recent guidelines suggest that for patients with spontaneous ICH on aspirin therapy requiring emergency neurosurgery, platelet transfusion might be considered to reduce postoperative bleeding and mortality 10 . However, this recommendation is based on a single randomized controlled trial (RCT) with methodological limitations and a narrow patient population, which may limit the applicability of its findings 23 . The potential adverse effects of platelet transfusion in neurosurgical patients could obscure the efficacy of DDAVP, leading to neutral results in our study. Concerns about the safety of DDAVP have centered on potential adverse events, including hyponatremia and thrombotic events. Current evidence suggests that DDAVP administration does not increase the incidence of thrombotic events in patients with ICH 7,18,19 . Given the potent antidiuretic effect of DDAVP, there is a risk of water retention, potentially leading to hyponatremia. Francoeur et al. have associated DDAVP with hyponatremia in the treatment of SAH 24 , while other studies have not observed significant changes in serum sodium levels in patients with ICH 8,18 . Our study, in conjunction with others, suggests that DDAVP usage was not significantly associated with SAEs for neurosurgical ICH patients. Further vigilance and additional research are essential to comprehensively assess its safety profile in this specific patient group. Our study, being retrospective, faces limitations due to documentation quality, such as unreliable antiplatelet medication use records and often unrecorded symptom onset times, which are crucial for assessing DDAVP's therapeutic window. The use of IPTW aimed to reduce confounding by indication, yet unmeasured confounding might still affect outcomes due to subjective decision-making in DDAVP administration. The study's diversity in antiplatelet therapy complicates the analysis further, as responses to DDAVP may vary across different regimens. Despite intentions for detailed subgroup analyses, the limited patient number restricted these efforts, and the absence of newer antiplatelet agents like ticagrelor limits our insights into DDAVP's effect on various platelet inhibitors. Additionally, despite conducting subgroup analyses according to different surgical methods, the lack of significant interactions could be attributed to the small sizes of these subgroups, raising the possibility of Type II errors. Although our study is the first to assess the impact of DDAVP in the neurosurgical context, it is limited by the number of eligible participants, resulting in insufficient statistical power to conclude its findings. Finally, conducted in a single country, our findings' applicability to a global context is constrained by a homogenous population. Addressing these challenges necessitates future RCTs with larger, more diverse cohorts to substantiate DDAVP's role in managing antiplatelet-associated ICH in neurosurgical settings. Conclusion This multi-center study demonstrated that there was no significant difference in mRS at discharge or SAEs between patients receiving DDAVP and those not receiving DDAVP among individuals with spontaneous antiplatelet-associated ICH undergoing neurosurgical interventions. Further RCTs are warranted to validate our findings and establish robust clinical guidelines for managing this complex clinical scenario. Declarations Acknowledgments and Author contributions Conceptualization, C.-C.Y., P.-T. H. and S.-C.C.; Acquisition of data, Z.-H. L., C.-C.C. and Y.-C. T.; Formal analysis, C.-C.Y.; Investigation, C.-H.C. and S.-C.C.; Resources, C.-C.Y., P.-T. H. and S.-C.C.; Supervision and Revising, C.-H.C. and C.-C.Y.; Writing – original draft, P.-T. H., S.-C.C. P.-T. H., S.-C.C contributed equally to this work. All authors have read and agreed to the published version of the manuscript. Ethics Approval and Consent to Participate The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Institutional Review Board of Chang Gung Medical Foundation (IRB no. 202302212B0C601, Date of Approval: 2024/01/29). Consent for publication This study qualified for a waiver of informed consent. Competing Interests: The authors declare no Competing Interests. Fundings: This study was funded by Chang-Gung Research Grant (CMRPVVN0181, CORPVVN0091, and CORPVVP0061). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. 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Cohort analysis of desmopressin effect on hematoma expansion in patients with spontaneous intracerebral hemorrhage and documented pre-ictus antiplatelet use. J Clin Neurosci 2019;66:33-37. DOI: 10.1016/j.jocn.2019.05.032. Kim JH, Baek CH, Min JY, Kim J-S, Kim SB, Kim H. Desmopressin improves platelet function in uremic patients taking antiplatelet agents who require emergent invasive procedures. Annals of Hematology 2015;94(9):1457-1461. DOI: 10.1007/s00277-015-2384-1. Baharoglu MI, Cordonnier C, Al-Shahi Salman R, et al. Platelet transfusion versus standard care after acute stroke due to spontaneous cerebral haemorrhage associated with antiplatelet therapy (PATCH): a randomised, open-label, phase 3 trial. Lancet 2016;387(10038):2605-2613. DOI: 10.1016/S0140-6736(16)30392-0. Li X, Sun Z, Zhao W, et al. Effect of acetylsalicylic acid usage and platelet transfusion on postoperative hemorrhage and activities of daily living in patients with acute intracerebral hemorrhage. J Neurosurg 2013;118(1):94-103. DOI: 10.3171/2012.9.JNS112286. Francoeur CL, Roh D, Schmidt JM, et al. Desmopressin administration and rebleeding in subarachnoid hemorrhage: analysis of an observational prospective database. Journal of Neurosurgery 2019;130(2):502-508. DOI: 10.3171/2017.7.jns17990. Tables Table 1. Baseline Characteristics of the overall population before and after inverse probability of treatment weighting Characteristics Before IPTW After IPTW (pseudo-population) DDAVP N = 26 Control N = 49 P value ASMD † DDAVP N = 69.9 Control N = 72.6 P value ASMD † Age (years), median [IQR] 71.0 [64.0-79.8] 67.0 [57.0-79.0] 0.497 0.108 68.0 [57.9-78.4] 67.0 [55.4-78.8] 0.577 0.135 Male, n (%) 19 (73.1) 37 (75.5) 1.000 0.056 48.7 (69.6) 55.1 (76.0) 0.640 0.144 BMI (kg/m 2 ), mean ± SD 24.6 ± 3.9 25.6 ± 3.5 0.250 0.276 24.5 ± 3.5 25.3 ± 3.4 0.379 0.227 Systolic blood pressure (mmHg), mean ± SD 183.6 ± 33.0 167.6 ± 44.7 0.112 0.408 179.0 ± 33.8 175.5 ± 47.0 0.744 0.087 Median GCS score, mean ± SD 9.0 ± 3.2 8.7 ± 3.4 0.701 0.094 9.1 ± 3.3 8.4 ± 3.5 0.532 0.196 Past medical history, n (%) Hypertension 22 (84.6) 44 (89.8) 0.711 0.156 63.8 (91.3) 65.7 (90.6) 0.909 0.025 Diabetes mellitus 11 (42.3) 23 (46.9) 0.889 0.093 22.2 (31.7) 30.4 (41.9) 0.442 0.213 Coronary artery disease 6 (23.1) 18 (36.7) 0.344 0.302 13.4 (19.2) 22.2 (30.5) 0.327 0.266 Chronic kidney disease 4 (15.4) 7 (14.3) 1.000 0.031 17.2 (24.6) 14.3 (19.7) 0.732 0.120 Prior ischemic stroke 16 (61.5) 31 (63.3) 1.000 0.036 48.2 (69.0) 44.6 (61.4) 0.585 0.159 Peripheral artery disease 0 (0.0) 2 (4.1) 0.541 0.292 0.0 (0.0) 3.0 (4.1) 0.174 0.293 Prior antiplatelet therapy, n (%) 0.147 0.490 0.937 0.106 Aspirin alone 23 (88.5) 38 (77.6) 55.0 (78.7) 58.1 (80.0) Clopidogrel alone 1 (3.8) 9 (18.4) 9.6 (13.7) 10.8 (14.9) Aspirin and Clopidogrel 2 (7.7) 2 (4.1) 5.3 (7.6) 3.7 (5.1) Preoperative platelet transfusion, n (%) 18 (69.2) 15 (30.6) 0.003 0.837 51.5 (73.6) 24.4 (33.6) 0.007 * 0.876 Preoperative tranexamic acid use, n (%) 12 (46.2) 22 (44.9) 1.000 0.025 27.5 (39.4) 33.9 (46.8) 0.614 0.150 Laboratory data Hemoglobin (g/dL), mean ± SD 13.3 ± 2.2 13.8 ± 1.9 0.311 0.243 13.4 ± 2.6 13.8 ± 1.9 0.637 0.165 Platelet (10 3 /uL), mean ± SD 217 ± 64 231 ± 59 0.346 0.227 225 ± 51 226 ± 59 0.944 0.016 INR, median [IQR] 1.0 [1.0-1.1] 1.0 [1.0-1.1] 0.271 0.297 1.0 [1.0, 1.0] 1.0 [1.0, 1.1] 0.197 0.304 Sodium (mEq/L), mean ± SD 139 ± 4 137 ± 3 0.038 0.486 137 ± 4 137 ± 3 0.783 0.087 ICH location, n (%) 0.900 0.103 0.982 0.053 Supratentorial deep 13 (50.0) 27 (55.1) 36.1 (51.7) 37.1 (51.2) Supratentorial lobar 6 (23.1) 10 (20.4) 13.1 (18.8) 15.1 (20.8) Infratentorial 7 (26.9) 12 (24.5) 20.7 (29.6) 20.4 (28.1) ICH etiology, n (%) 0.958 0.150 0.926 0.162 Hypertensive 20 (76.9) 38 (77.6) 56.4 (80.7) 56.4 (77.7) Cerebral amyloid angiopathy 3 (11.5) 4 (8.2) 7.4 (10.6) 6.8 (9.4) Hemorrhagic transformation 2 (7.7) 4 (8.2) 4.6 (6.5) 5.9 (8.1) Cryptogenic atypical ICH 1 (3.8) 3 (6.1) 1.5 (2.2) 3.5 (4.8) ICH volume, median [IQR] 40.0 [19.9-60.0] 31.0 [16.5-61.0] 0.593 0.152 30.0 [10.0-59.2] 31.0 [16.6-60.9] 0.567 0.075 Total ICH score, median [IQR] 3.0 [2.0-3.0] 2.0 [2.0-3.0] 0.270 0.233 3.0 [2.0-3.0] 3.0 [2.0-3.0] 0.982 0.075 Age > 80 years 7 (26.9) 8 (16.3) 11.6 (16.6) 11.5 (15.8) GCS score 13-15 5 (19.2) 9 (18.4) 16.4 (23.4) 12.1 (16.7) 5-12 20 (76.9) 37 (75.5) 50.4 (72.1) 52.9 (72.9) 3-4 1 (3.8) 3 (6.1) 3.1 (4.5) 7.5 (10.4) ICH volume>30 ml 15 (57.7) 25 (51.0) 33.0 (47.2) 38.8 (53.5) Intraventricular extension 20 (76.9) 36 (73.5) 59.2 (84.7) 54.7 (75.4) Infratentorial ICH location 7 (26.9) 12 (24.5) 20.7 (29.6) 20.4 (28.1) Operative intervention, n (%) 0.960 0.072 0.274 0.330 Craniotomy 15 (57.7) 30 (61.2) 33.6 (48.0) 46.6 (64.2) External ventricular drain only 11 (42.3) 19 (38.8) 36.4 (52.0) 26.0 (35.8) IPTW: inverse probability of treatment weighting; DDAVP: desmopressin acetate; ASMD: absolute standardized mean difference; BMI: body mass index; IQR: interquartile range; SD: standard deviation; GCS: Glasgow Coma Scale; INR: international normalized ratio; ICH: intracerebral hemorrhage. †Values greater than 0.1 indicate a nonnegligible difference between the two groups. * P value < 0.05. Table 2. Comparison of Perioperative records and clinical outcomes before and after inverse probability of treatment weighting Clinical outcomes Before IPTW After IPTW (pseudo-population) DDAVP N = 26 Control N = 49 P value DDAVP N = 69.9 Control N = 72.6 P value Perioperative records Intraoperative bleeding volume (ml), median [IQR] 100 [10-200] 200 [15-400] 0.316 20 [10-215] 200 [17-505] 0.200 Surgical evacuation 200 [125-500] 300 [200-600] 0.169 253 [115-500] 364 [200-600] 0.609 External ventricular drain only 10 [10-10] 20 [10-20] 0.655 10 [10-10] 10 [8-20] 0.286 Blood transfusion volume (ml), median [IQR] 0 [0-293] 0 [0-564] 0.305 0 [0-250] 76 [0-588] 0.288 Surgical evacuation 210 [0-652] 422 [0-791] 0.482 276 [0-763] 500 [0-848] 0.970 External ventricular drain only 0 [0-0] 0 [0-0] 0.173 0 [0-0] 0 [0-0] 0.093 Operation time (min), median [IQR] 133 [74-197] 170 [94-234] 0.295 105 [58-168] 186 [94-235] 0.253 Surgical evacuation 168 [149-269] 212 [186-269] 0.268 184 [157-329] 220 [187-269] 0.794 External ventricular drain only 58 [54-93] 87 [64-96] 0.312 72 [56-94] 80 [58-96] 0.963 SAE during hospitalization, n (%) Rebleeding 4 (15.4) 15 (30.6) 0.244 10.9 (15.6) 26.6 (36.7) 0.131 Neurologic deterioration 12 (46.2) 21 (42.9) 0.977 29.0 (41.5) 30.0 (41.4) 0.995 ICH enlargement 3 (11.5) 12 (24.5) 0.234 9.7 (13.9) 21.9 (30.1) 0.233 Brain herniation 4 (15.4) 4 (8.2) 0.437 10.7 (15.3) 7.1 (9.8) 0.535 Intraventricular extension 3 (11.5) 3 (6.1) 0.412 5.0 (7.1) 3.6 (5.0) 0.670 Hydrocephalus 9 (34.6) 12 (24.5) 0.510 14.6 (20.9) 17.6 (24.2) 0.748 Hyponatremia 1 (3.8) 9 (18.4) 0.150 4.2 (5.9) 16.1 (22.2) 0.160 Thromboembolism 3 (11.5) 2 (4.1) 0.334 6.4 (9.1) 4.0 (5.5) 0.584 Infection 17 (65.4) 35 (71.4) 0.782 38.1 (54.5) 51.7 (71.3) 0.247 Epileptic seizures 8 (30.8) 10 (20.4) 0.474 21.0 (30.1) 14.0 (19.3) 0.402 Transfusion-related adverse events 0 (0) 1 (2.0) 1.000 0 (0) 2.2 (3.0) 0.325 In-hospital and follow-up outcomes Length of hospital stay, median [IQR] 30.0 [23.0-47.3] 29.0 [23.0-49.0] 0.854 28.0 [16.4-48.5] 34.0 [23.1-52.0] 0.602 Length of ICU stay, median [IQR] 11.5 [6.0-27.8] 8.0 [4.0-19.0] 0.155 9.4 [4.3-27.7] 8.0 [4.0-21.0] 0.741 In-hospital mortality, n (%) 5 (19.2) 7 (14.3) 0.742 11.9 (17.0) 10.1 (13.9) 0.747 Readmission to neurosurgical wards within 30 days, n (%) 0 (0.0) 1 (2.0) 1.000 0.0 (0.0) 1.2 (1.6) 0.337 mRS score at discharge, n (%) 1.000 0.533 0-3 4 (15.4) 8 (16.3) 15.8 (22.6) 10.8 (14.9) 4-6 22 (84.6) 41 (83.7) 54.1 (77.4) 61.8 (85.1) IQR: interquartile range; IPTW: inverse probability of treatment weighting; DDAVP: desmopressin acetate; SAE: serious adverse event; ICH: intracerebral hemorrhage; mRS: modified Rankin Scale Supplementary Files STROBEchecklistv4combined.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4440555","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":307418093,"identity":"cd7e4ee5-e119-4876-ae3b-699a17586985","order_by":0,"name":"Pang-Ting Hsu","email":"","orcid":"","institution":"Chang Gung Memorial Hospital Linkou Main Branch: Chang Gung Memorial Hospital Linkou","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Pang-Ting","middleName":"","lastName":"Hsu","suffix":""},{"id":307418094,"identity":"e8a16155-1cc7-4dba-9b0f-8126fe164871","order_by":1,"name":"Chien Shuo-Chi","email":"","orcid":"","institution":"Chang Gung Memorial Hospital Linkou Main Branch: Chang Gung Memorial Hospital Linkou","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Chien","middleName":"","lastName":"Shuo-Chi","suffix":""},{"id":307418095,"identity":"3bf0e9ed-33c8-4077-86f2-825a2f6d4a13","order_by":2,"name":"Ching-Chang Chen","email":"","orcid":"","institution":"Chang Gung Memorial Hospital Linkou Main Branch: Chang Gung Memorial Hospital Linkou","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Ching-Chang","middleName":"","lastName":"Chen","suffix":""},{"id":307418096,"identity":"1a184b80-4c24-4780-b758-450538627ac3","order_by":3,"name":"Zhuo-Hao Liu","email":"","orcid":"","institution":"Chang Gung Memorial Hospital Linkou Main Branch: Chang Gung Memorial Hospital Linkou","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Zhuo-Hao","middleName":"","lastName":"Liu","suffix":""},{"id":307418097,"identity":"eb476b0d-f0bc-4c99-a671-2869deeb2f82","order_by":4,"name":"Chi-Cheng Chuang","email":"","orcid":"","institution":"Chang Gung Memorial Hospital Linkou Main Branch: Chang Gung Memorial Hospital Linkou","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Chi-Cheng","middleName":"","lastName":"Chuang","suffix":""},{"id":307418098,"identity":"0092373d-eed3-44c0-bd4a-8cc8d931d558","order_by":5,"name":"Yu-Chen Tsai","email":"","orcid":"","institution":"Chang Gung Memorial Hospital Linkou Main Branch: Chang Gung Memorial Hospital Linkou","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Yu-Chen","middleName":"","lastName":"Tsai","suffix":""},{"id":307418099,"identity":"8cd977a2-10e5-4e0d-ba2a-a11ab9b68cfe","order_by":6,"name":"Chung-Hsien Chaou","email":"","orcid":"","institution":"Chang Gung Memorial Hospital Linkou Main Branch: Chang Gung Memorial Hospital Linkou","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Chung-Hsien","middleName":"","lastName":"Chaou","suffix":""},{"id":307418100,"identity":"671a8673-d66e-4dbd-b564-80284bcea986","order_by":7,"name":"Chieh-Ching Yen","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+klEQVRIiWNgGAWjYDACCcYGZgaGAzwMDPwfDD4ABdjYidfCYFA4A6SFmaAWBgaQFhDT4DNIIwMhLfyzmxsfF9TckTHnX5C42ebXNnk+ZgbGDx9z8Fhy52Cz8Yxjz3gsZzw4bJzbd9uwjZmBWXLmNtxaDCQS26R5Gw7zGNw42Gac23ObEaiFjZkXv5b23xAth9l/W/bctidGSxszWMv5NgZjhh+3EwlqkbiR2CzNcwxkCw+DYW/D7eQ2ZsZmvH7hn5H+8DNPzWF7g/NnGAx+/LltO7+9+eCHj3i0INmXwMDA2AZiMTYQox5k3wEg8YdIxaNgFIyCUTCiAACNk1N/h5FqqAAAAABJRU5ErkJggg==","orcid":"","institution":"New Taipei City Municipal Tucheng Hospital","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Chieh-Ching","middleName":"","lastName":"Yen","suffix":""}],"badges":[],"createdAt":"2024-05-18 10:08:59","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4440555/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4440555/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":58224412,"identity":"86313ecf-8ca7-441c-99ba-78593e2490eb","added_by":"auto","created_at":"2024-06-12 17:37:32","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":1075798,"visible":true,"origin":"","legend":"\u003cp\u003ePatient inclusion flowchart. SAH: subarachnoid hemorrhage; SDH: subdural hematoma; IVH: intraventricular hemorrhage; DOAC: direct oral anticoagulant; EMR: electronic medical record; DDAVP: desmopressin acetate.\u003c/p\u003e","description":"","filename":"OnlineFigure1flowdiagram.bak4K.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4440555/v1/7470bb826e0e4806d68a8da9.jpg"},{"id":58224414,"identity":"6e6dae2e-c34f-4c9c-9c0d-2e283433a7aa","added_by":"auto","created_at":"2024-06-12 17:37:32","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":739446,"visible":true,"origin":"","legend":"\u003cp\u003eMultivariable logistic regression analysis using generalized estimating equations method to explore the odds of multiple outcomes. aOR: adjusted odds ratio; mRS: modified Rankin Scale; SAE: serious adverse event; ICH: intracerebral hemorrhage; ICU: intensive care unit; DDAVP: desmopressin acetate.\u003c/p\u003e","description":"","filename":"OnlineFigure2outcomeforest4K.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4440555/v1/a4276c87c3fbdec62ed3d28c.jpg"},{"id":58224413,"identity":"9bef8b40-c922-4a2a-87f5-01ba041b7dbc","added_by":"auto","created_at":"2024-06-12 17:37:32","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":390617,"visible":true,"origin":"","legend":"\u003cp\u003eSubgroup analyses for the primary outcome in prespecified subgroups. aOR: adjusted odds ratio; mRS: modified Rankin Scale; EVD: external ventricular drain; ICH: intracerebral hemorrhage; DDAVP: desmopressin acetate.\u003c/p\u003e","description":"","filename":"OnlineFigure3subgroupforest4K.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4440555/v1/0c3b5a61e01231e65252b692.jpg"},{"id":59957665,"identity":"ea49810a-08c7-4fc6-a1df-f35245982b0d","added_by":"auto","created_at":"2024-07-09 21:08:52","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":3057200,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4440555/v1/0f2aeb29-aed8-4b6b-b10e-a1a10de337c5.pdf"},{"id":58224411,"identity":"deabfa24-c271-479b-8a5c-3e20504c5734","added_by":"auto","created_at":"2024-06-12 17:37:32","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":34384,"visible":true,"origin":"","legend":"","description":"","filename":"STROBEchecklistv4combined.docx","url":"https://assets-eu.researchsquare.com/files/rs-4440555/v1/4437051da2b98793bbc35940.docx"}],"financialInterests":"","formattedTitle":"Impact of Desmopressin on Clinical Outcomes in Patients with Spontaneous Antiplatelet-Associated Intracerebral Hemorrhage Undergoing Neurosurgical Intervention: An Observational Multi-Center Study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAcute spontaneous intracerebral hemorrhage (ICH) poses a significant medical challenge, often resulting in severe morbidity and, in some cases, mortality. Accounting for approximately 10% of cerebral vascular accidents, spontaneous ICH warrants attention due to its potentially life-threatening implications\u003csup\u003e1,2\u003c/sup\u003e. The situation becomes more intricate when patients previously under antiplatelet or anticoagulant regimens encounter hemorrhagic emergencies, particularly when surgical intervention is on the horizon. While prompt cessation of medication and immediate reversal are recommended for those on anticoagulants, the appropriate management for antiplatelet-associated situations remains a subject of debate\u003csup\u003e3\u0026ndash;6\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eDesmopressin (1-deamino-8-D-arginine vasopressin; DDAVP), known for its efficacy in treating bleeding in patients with platelet dysfunction or those on antiplatelet agents, has been investigated for its potential to limit hematoma expansion in antiplatelet-associated ICH patients\u003csup\u003e7\u0026ndash;9\u003c/sup\u003e. However, to date, there exists a void in the literature regarding the use of DDAVP in the context of neurosurgery for spontaneous ICH patients who were previously on antiplatelet therapy. This multi-center, real-world study aims to fill this knowledge gap by providing a comprehensive evaluation of the efficacy and safety of DDAVP therapy in spontaneous ICH patients with a history of antiplatelet use and a concurrent need for neurosurgical intervention.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design and Setting\u003c/h2\u003e \u003cp\u003eThis multi-center observational study was conducted using data from the emergency departments (EDs) of two medical centers and one regional hospital in Taiwan, all of which utilized a shared electronic medical records system (EMRs). Collectively, these hospitals have more than 7,000 beds and annually accommodate approximately 350,000 emergency department visits. The study included all adult patients who fulfilled the inclusion criteria from January 1, 2016, to November 30, 2023. The institutional review board (IRB) of the Chang Gung Medical Foundation reviewed and approved on January 29, 2024 (IRB no. 202302212B0C601), ensuring compliance with the Declaration of Helsinki. The IRB waived the need for informed consent, adhering to the STROBE guideline.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003ePatient Selection and Data Collection\u003c/h2\u003e \u003cp\u003eBy conducting a computerized search of the EMRs within the study timeframe, we identified all adult patients who presented with spontaneous ICH in the EDs based on International Classification of Diseases (ICD)-10 codes from I61.0 to I61.9. Patients were included if they were reportedly taking antiplatelet therapy for at least one week prior to admission and diagnosed with a new spontaneous ICH who underwent subsequent neurosurgical intervention (i.e., surgical evacuation or external ventricular drain (EVD)). The determination of patients taking antiplatelet medications is based on EMR documentation.\u003c/p\u003e \u003cp\u003eIn our institutions, emergency physicians conduct computed tomography (CT) scans of the brain for patients suspected of cerebrovascular accidents. Consultation with neurosurgeons and neurologists is standard practice upon the diagnosis of spontaneous ICH on brain CT. Following the guidelines for managing spontaneous ICH, craniotomy for surgical evacuation of the hematoma is recommended for patients with lobar clots exceeding 30 ml and located within 1 cm of the brain surface. In cases of cerebellar ICH, surgical evacuation is indicated for hematomas larger than 3 cm in diameter, those causing brainstem compression, or presenting with hydrocephalus. Conversely, for patients with thalamic hemorrhage that has ruptured into the ventricle, EVD is the recommended course of action \u003csup\u003e1,10\u0026ndash;12\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe treatment plan is formulated through collaborative discussions involving neurosurgeons, neurologists, and emergency physicians. Shared decision-making with the patient and their family is integral, especially in cases of acute spontaneous ICH associated with antiplatelet therapy. The multidisciplinary team decision also extends to preoperative interventions such as blood transfusion of platelet concentrate (a single transfusion of 12 to 24 units) and/or the administration of desmopressin (DDAVP) (a single dose of 0.4 \u0026micro;g/kg IV).\u003c/p\u003e \u003cp\u003ePatients were excluded if they had traumatic brain injury, were diagnosed with ICH due to subarachnoid hemorrhage (SAH), arteriovenous malformation, or an intracranial tumor, or had coagulopathies including concomitant treatment with anticoagulant medications, acquired or inherent coagulopathic disease, international normalized ratio (INR)\u0026thinsp;\u0026gt;\u0026thinsp;1.5, or platelet count\u0026thinsp;\u0026lt;\u0026thinsp;100,000/uL within 24 h of ICH. Eligible patients were then stratified into two groups, with those who received DDAVP before surgical intervention and those who did not. The records of the patients selected with EMRs were manually reviewed by two physicians for the verification of their inclusion eligibility (P.-T. H. and S.-C. C.).\u003c/p\u003e \u003cp\u003ePatient characteristics collected included demographics, hospital institution, clinical course, presenting blood pressure, relevant past medical history, antiplatelet medications, initial Glasgow Coma Scale (GCS) score and ICH score within 24 h of ICH diagnosis. We collected laboratory data during the initial presentation, including serum hemoglobin levels, platelet count, INR, and sodium levels. Follow-up post-operative sodium levels within 48 hours were also obtained. Preoperative medication with tranexamic acid, platelet transfusion and DDAVP dose were documented. Surgical records including operation time, intraoperative bleeding volume, and blood transfusion volume were collected. CT scans were utilized for brain imaging analyses. Independent assessments of ICH volume, location, the presence of intraventricular hemorrhage (IVH) and hydrocephalus were conducted by a neuroradiologist (Y.-C. T.) and a neurosurgeon (Z.-H. L.). These evaluations, which both raters performed while blinded to baseline characteristics, treatment, and clinical outcomes, ensured an unbiased approach.\u003c/p\u003e \u003cp\u003eThe primary outcome was the functional outcome at discharge, scored with the modified Rankin Scale (mRS)\u003csup\u003e13\u0026ndash;15\u003c/sup\u003e. Secondary endpoints included safety outcomes for serious adverse events (SAEs) during hospitalization (including rebleeding, neurologic deterioration, newly developed brain herniation, intraventricular hematoma extension or hydrocephalus, thromboembolism, hyponatremia, infection with pneumonia and urinary tract infection, epileptic seizure, and adverse transfusion reactions), in-hospital and follow-up outcomes (including in-hospital mortality, length of hospital stays, and readmission to neurosurgical wards within 30 days). Occurrence of thromboembolism, including deep vein thrombosis, acute ischemic stroke, myocardial infarction, and pulmonary embolism, was evaluated within 7 days of admission. These were confirmed by diagnostic test results (including doppler ultrasound, brain CT scan, or additional neurological imagining) during hospitalization. Neurologic deterioration was defined according to any of the following criteria: (1) deterioration of Glasgow Coma Scale (GCS) score, (2) diminished muscle strength in the extremities, (3) occurrence of seizure attacks, (4) persistence or prolongation of symptoms such as headache, dizziness, or vomiting, and (5) signs of increased intracranial pressure, including hypertension, bradycardia, and irregular breathing patterns\u003csup\u003e16,17\u003c/sup\u003e. Rebleeding was defined as neurologic deterioration in conjunction with increased hemorrhage burden on a repeated brain CT. Hyponatremia was defined as serum sodium\u0026thinsp;\u0026lt;\u0026thinsp;135 mEq/L within 48 hours of admission after the operation.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eWe calculated descriptive statistics as numbers and percentages for categorical data, while parametric and non-parametric continuous variables were reported as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviations (SD) or median [interquartile ranges] (IQR), respectively. Normality of data distribution was determined by the Shapiro-Wilks test and histogram visualization. Categorical variables were compared using Pearson's chi-square or Fisher's exact test, while continuous variables were compared using the independent Student's t-test for normally distributed data, or the Wilcoxon rank-sum test for non-normally distributed data, as appropriate.\u003c/p\u003e \u003cp\u003eTo generate more homogeneous comparisons between the DDAVP and the control group, we used propensity scores with inverse probability of treatment weighting (IPTW) for the main and subgroup analyses. We adopted IPTW adjustment in this study because it could provide average treatment effects in the whole study population that mimic the target inference from randomized clinical trials. Propensity scores were calculated with a binary logistic regression for receiving DDAVP using the following baseline characteristics as the independent variables: age, gender, BMI, presenting blood pressure, GCS score, past medical history, prior type of antiplatelet therapy, preoperative platelet transfusion, preoperative tranexamic acid treatment, laboratory data, operative method, and ICH location, etiology, volume, and score, as listed in Table\u0026nbsp;1. Between-group differences were assessed using the absolute standardized mean differences obtained from the two pairwise comparisons of DDAVP and control groups, with a cutoff value\u0026thinsp;\u0026lt;\u0026thinsp;0.1 being considered well balanced.\u003c/p\u003e \u003cp\u003eTo assess the association between DDAVP administration and clinical outcomes, we employed a multivariable generalized estimating equation (GEE) logistic regression model with an exchangeable correlation structure. We used cluster-robust standard errors, with individual hospitals serving as clusters within the IPTW cohort. The multivariable model was adjusted for each covariate that continued to exhibit a standardized difference greater than 0.1 after balancing between the two groups. We planned to perform four prespecified subgroup analyses to evaluate treatment-by-covariate interactions to explore the heterogeneity of the treatment effects across different covariates, including operative method (surgical evacuation vs EVD only), type of antiplatelet therapy regimen (single vs dual), preoperative platelet transfusion (yes vs no), and ICH volume (\u0026gt;\u0026thinsp;30 ml vs \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\le\\)\u003c/span\u003e\u003c/span\u003e 30ml). The results of each model were summarized using odds ratios (ORs) and their corresponding 95% confidence intervals (CIs). All reported \u003cem\u003ep\u003c/em\u003e values were two-sided, and we considered \u003cem\u003ep\u003c/em\u003e values less than 0.05 as statistically significant. These analyses were conducted using R version 4.1.2 (R Foundation for Statistical Computing, Vienna, Austria).\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eBaseline characteristics\u003c/h2\u003e \u003cp\u003eA total of 75 patients were studied, comprising 26 patients treated with DDAVP and 49 patients in the control group (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). After IPTW adjustments, there were no significant differences in baseline characteristics, including age, gender, body mass index (BMI), systolic blood pressure, GCS score, past medical history, prior antiplatelet therapy, preoperative tranexamic acid use, laboratory data, ICH location, ICH etiology, ICH volume, ICH score, and operative method (Table\u0026nbsp;1). However, preoperative platelet transfusion remained significantly different between the two groups (73.6% vs 33.6%; \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.007).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003ePerioperative records and outcome measures\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;2 presents the perioperative records and outcome measures for both the DDAVP and control groups. Following IPTW adjustment, no significant differences were observed in the intraoperative bleeding volume, blood transfusion volume, and operation time between the two groups. In the secondary analysis, where perioperative records were grouped by operative method (i.e., surgical evacuation or EVD only), no significant differences were found between the DDAVP and control groups.\u003c/p\u003e \u003cp\u003eFor the primary outcome, there were no significant differences in mRS of 4\u0026ndash;6 at discharge between groups (77.4% vs 85.1%; \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.533) after IPTW adjustment. SAEs occurred in 66 patients (88%). Safety outcomes did not differ significantly between groups before and after IPTW adjustment. Regarding in-hospital and follow-up outcomes, there were no significant differences in length of hospital stay, length of ICU stay, in-hospital mortality, and readmission to neurosurgical wards within 30 days before and after IPTW adjustment.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eMultivariable analyses and subgroup analyses for the outcomes\u003c/h2\u003e \u003cp\u003eWe performed multivariable GEE logistic regression with adjustment for each unbalanced covariate from baseline characteristics after IPTW (Table\u0026nbsp;1). The model demonstrated that DDAVP was not significantly associated with improved functional outcome, safety outcomes, in-hospital, or follow-up outcomes (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). In the prespecified subgroup analyses, operative method, preoperative platelet transfusion, and ICH volume had no significant interaction with the effect of the DDAVP versus control group (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). Type of antiplatelet therapy was not performed for subgroup analysis since there were only four patients receiving dual antiplatelet therapy.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eOur study presents a novel examination of the role of DDAVP in the management of patients with spontaneous antiplatelet-associated ICH undergoing neurosurgical interventions. The findings indicate that DDAVP administration does not significantly influence the functional outcome, nor does it appear to increase the SAEs or reduce the risk of mortality among this patient population. This observation was consistent across predefined subgroups and remained even after adjustments for unbalanced covariates from baseline characteristics after IPTW. To the best of our knowledge, this study is the first to assess the impact of DDAVP on clinical outcomes in patients with antiplatelet-associated ICH necessitating neurosurgical interventions.\u003c/p\u003e \u003cp\u003eSeveral observational studies have explored the effects of ICH in patients on antiplatelet therapy, focusing primarily on outcomes related to hematoma expansion and, in fewer instances, neurologic function. The findings from these studies have been mixed. Feldman et al. identified an association between DDAVP use and a reduced risk of hematoma expansion, defined as an increase of 3 mL or more, in patients with spontaneous ICH (DDAVP, 10.9% vs no DDAVP, 36.2%; \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.002)\u003csup\u003e18\u003c/sup\u003e. Similarly, Barletta et al. found that DDAVP administration in patients with traumatic brain injuries or spontaneous ICH was correlated with a lower incidence of hematoma expansion (DDAVP, 14% vs no DDAVP, 30%; \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.015)\u003csup\u003e19\u003c/sup\u003e. Conversely, Summers et al. observed a comparable frequency of hematoma expansion, defined as a\u0026thinsp;\u0026gt;\u0026thinsp;20% increase from baseline, between DDAVP and non-DDAVP groups (16.1% vs 17.6%; \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.78)\u003csup\u003e9\u003c/sup\u003e. McManus et al. reported similar rates of hematoma expansion, either \u0026gt;\u0026thinsp;33% or a 12.5 mL increase from baseline (DDAVP, 11.8% vs no DDAVP, 11.1%; \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.99)\u003csup\u003e8\u003c/sup\u003e. Schmidt et al. included patients with spontaneous ICH and noted no significant changes in hematoma size, defined as a\u0026thinsp;\u0026ge;\u0026thinsp;6 mL increase from baseline (DDAVP, 30% vs no DDAVP, 28%; \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.82)\u003csup\u003e20\u003c/sup\u003e. Mengel et al. evaluated the combined impact of DDAVP and platelet transfusion in spontaneous ICH patients, finding no significant reduction in hematoma expansion, defined as \u0026ge;\u0026thinsp;33% increase from baseline (DDAVP, 22% vs no DDAVP, 22%; \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.98)\u003csup\u003e7\u003c/sup\u003e. In terms of functional outcomes, Mengel et al. observed that patients not receiving DDAVP and platelet transfusion exhibited better three-month functional outcome (mRS\u0026thinsp;\u0026le;\u0026thinsp;3; DDAVP, 31.9% vs no DDAVP, 51.5%; \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.024)\u003csup\u003e7\u003c/sup\u003e. Feldman et al. saw no significant differences in discharge mRS between the groups (DDAVP, 4 vs no DDAVP, 4; \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.483)\u003csup\u003e18\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eA limited number of studies have examined the effect of DDAVP on patients undergoing non-cardiac surgery. In the context of neurosurgical interventions, only a single study by Francoeur et al. assessed outcomes in 1,639 SAH patients undergoing angiography and either surgical or endovascular treatment, with and without DDAVP\u003csup\u003e21\u003c/sup\u003e. Of these, 143 (9%) received DDAVP upon admission. The findings suggested DDAVP was associated with a 45% reduction in the risk of rebleeding, regardless of previous antiplatelet medication use (DDAVP, 4% vs. no DDAVP, 9%, adjusted OR 0.55, 95% CI 0.27\u0026ndash;0.97), and a 47% improvement in the odds of a favorable neurological outcome (OR, 1.47; 95% CI, 1.06\u0026ndash;2.03). In contrast, our study indicated that DDAVP was not significantly associated with decreased rebleeding rates or improved functional outcomes, diverging from Francoeur et al.'s findings. Several factors may account for these discrepancies. First, our research focused on patients with spontaneous ICH, a condition distinct from the SAH cases Francoeur et al. examined. Second, in their study, patients treated with antiplatelet therapy constituted a minor proportion of 12%, though they adjusted for this variable in their outcomes. Third, we defined functional outcome as the mRS at discharge, whereas Francoeur et al. assessed mRS in survivors at three months, a methodological difference that could introduce survivorship bias.\u003c/p\u003e \u003cp\u003eIt is important to highlight that our study observed a significantly higher rate of platelet transfusion in the DDAVP group compared to the control group (69.2% vs 30.6%, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.003). The PATCH trial indicated that for patients with spontaneous ICH not undergoing surgery, platelet transfusion did not reduce hematoma expansion, death, or dependence\u003csup\u003e22\u003c/sup\u003e. Instead, it was associated with a marginally increased risk of SAEs. Conversely, recent guidelines suggest that for patients with spontaneous ICH on aspirin therapy requiring emergency neurosurgery, platelet transfusion might be considered to reduce postoperative bleeding and mortality\u003csup\u003e10\u003c/sup\u003e. However, this recommendation is based on a single randomized controlled trial (RCT) with methodological limitations and a narrow patient population, which may limit the applicability of its findings\u003csup\u003e23\u003c/sup\u003e. The potential adverse effects of platelet transfusion in neurosurgical patients could obscure the efficacy of DDAVP, leading to neutral results in our study.\u003c/p\u003e \u003cp\u003eConcerns about the safety of DDAVP have centered on potential adverse events, including hyponatremia and thrombotic events. Current evidence suggests that DDAVP administration does not increase the incidence of thrombotic events in patients with ICH\u003csup\u003e7,18,19\u003c/sup\u003e. Given the potent antidiuretic effect of DDAVP, there is a risk of water retention, potentially leading to hyponatremia. Francoeur et al. have associated DDAVP with hyponatremia in the treatment of SAH\u003csup\u003e24\u003c/sup\u003e, while other studies have not observed significant changes in serum sodium levels in patients with ICH\u003csup\u003e8,18\u003c/sup\u003e. Our study, in conjunction with others, suggests that DDAVP usage was not significantly associated with SAEs for neurosurgical ICH patients. Further vigilance and additional research are essential to comprehensively assess its safety profile in this specific patient group.\u003c/p\u003e \u003cp\u003eOur study, being retrospective, faces limitations due to documentation quality, such as unreliable antiplatelet medication use records and often unrecorded symptom onset times, which are crucial for assessing DDAVP's therapeutic window. The use of IPTW aimed to reduce confounding by indication, yet unmeasured confounding might still affect outcomes due to subjective decision-making in DDAVP administration. The study's diversity in antiplatelet therapy complicates the analysis further, as responses to DDAVP may vary across different regimens. Despite intentions for detailed subgroup analyses, the limited patient number restricted these efforts, and the absence of newer antiplatelet agents like ticagrelor limits our insights into DDAVP's effect on various platelet inhibitors. Additionally, despite conducting subgroup analyses according to different surgical methods, the lack of significant interactions could be attributed to the small sizes of these subgroups, raising the possibility of Type II errors. Although our study is the first to assess the impact of DDAVP in the neurosurgical context, it is limited by the number of eligible participants, resulting in insufficient statistical power to conclude its findings. Finally, conducted in a single country, our findings' applicability to a global context is constrained by a homogenous population. Addressing these challenges necessitates future RCTs with larger, more diverse cohorts to substantiate DDAVP's role in managing antiplatelet-associated ICH in neurosurgical settings.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis multi-center study demonstrated that there was no significant difference in mRS at discharge or SAEs between patients receiving DDAVP and those not receiving DDAVP among individuals with spontaneous antiplatelet-associated ICH undergoing neurosurgical interventions. Further RCTs are warranted to validate our findings and establish robust clinical guidelines for managing this complex clinical scenario.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch1\u003eAcknowledgments and Author contributions\u003c/h1\u003e\n\u003cp\u003eConceptualization, C.-C.Y., P.-T. H. and S.-C.C.; Acquisition of data, Z.-H. L., C.-C.C. and Y.-C. T.; Formal analysis, C.-C.Y.; Investigation, C.-H.C. and S.-C.C.; Resources, C.-C.Y., P.-T. H. and S.-C.C.; Supervision and Revising, C.-H.C. and C.-C.Y.; Writing \u0026ndash; original draft, P.-T. H., S.-C.C. P.-T. H., S.-C.C contributed equally to this work. All authors have read and agreed to the published version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics Approval and Consent to Participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Institutional Review Board of Chang Gung Medical Foundation (IRB no. 202302212B0C601, Date of Approval: 2024/01/29).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study qualified for a waiver of informed consent.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no Competing Interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFundings:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was funded by Chang-Gung Research Grant (CMRPVVN0181, CORPVVN0091, and CORPVVP0061). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCheck list\u003c/strong\u003e\u003cstrong\u003e:\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;STROBE\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;check list\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatement:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis manuscript has not been published elsewhere and is not under consideration by another journal and manuscript complies with all instructions to authors has been confirmed\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eCordonnier C, Demchuk A, Ziai W, Anderson CS. Intracerebral haemorrhage: current approaches to acute management. Lancet 2018;392(10154):1257-1268. DOI: 10.1016/S0140-6736(18)31878-6.\u003c/li\u003e\n\u003cli\u003eTsao CW, Aday AW, Almarzooq ZI, et al. Heart Disease and Stroke Statistics-2022 Update: A Report From the American Heart Association. Circulation 2022;145(8):e153-e639. DOI: 10.1161/CIR.0000000000001052.\u003c/li\u003e\n\u003cli\u003eFrontera JA, Lewin JJ, 3rd, Rabinstein AA, et al. Guideline for Reversal of Antithrombotics in Intracranial Hemorrhage: A Statement for Healthcare Professionals from the Neurocritical Care Society and Society of Critical Care Medicine. Neurocrit Care 2016;24(1):6-46. DOI: 10.1007/s12028-015-0222-x.\u003c/li\u003e\n\u003cli\u003eBirch TB. To Transfuse or Not to Transfuse: Which Patients Benefit From Transfusion in Antiplatelet Associated Intracerebral Hemorrhage? Crit Care Med 2020;48(7):1085-1087. DOI: 10.1097/CCM.0000000000004358.\u003c/li\u003e\n\u003cli\u003eArnone GD, Kumar P, Wonais MC, et al. Impact of Platelet Transfusion on Intracerebral Hemorrhage in Patients on Antiplatelet Therapy-An Analysis Based on Intracerebral Hemorrhage Score. World Neurosurg 2018;111:e895-e904. DOI: 10.1016/j.wneu.2018.01.006.\u003c/li\u003e\n\u003cli\u003eMorris NA, Patel N, Galvagno SM, Jr., et al. The effect of platelet transfusion on functional independence and mortality after antiplatelet therapy associated spontaneous intracerebral hemorrhage: A systematic review and meta-analysis. J Neurol Sci 2020;417:117075. DOI: 10.1016/j.jns.2020.117075.\u003c/li\u003e\n\u003cli\u003eMengel A, Stefanou MI, Hadaschik KA, et al. Early Administration of Desmopressin and Platelet Transfusion for Reducing Hematoma Expansion in Patients With Acute Antiplatelet Therapy Associated Intracerebral Hemorrhage. Crit Care Med 2020;48(7):1009-1017. DOI: 10.1097/CCM.0000000000004348.\u003c/li\u003e\n\u003cli\u003eMcManus J, Ferreira J, Jones GM, et al. Effect of desmopressin acetate on acute spontaneous intracranial hemorrhage in patients on antiplatelet therapy. J Neurol Sci 2022;434:120142. (In eng). DOI: 10.1016/j.jns.2022.120142.\u003c/li\u003e\n\u003cli\u003eSummers A, Singh J, Lai M, et al. A multicenter retrospective study evaluating the impact of desmopressin on hematoma expansion in patients with antiplatelet-associated intracranial hemorrhage. Thromb Res 2023;222:96-101. (In eng). DOI: 10.1016/j.thromres.2022.12.016.\u003c/li\u003e\n\u003cli\u003eGreenberg SM, Ziai WC, Cordonnier C, et al. 2022 Guideline for the Management of Patients With Spontaneous Intracerebral Hemorrhage: A Guideline From the American Heart Association/American Stroke Association. Stroke 2022;53(7):e282-e361. (In eng). DOI: 10.1161/str.0000000000000407.\u003c/li\u003e\n\u003cli\u003eRodr\u0026iacute;guez-Y\u0026aacute;\u0026ntilde;ez M, Castellanos M, Freijo MM, et al. Clinical practice guidelines in intracerebral haemorrhage. Neurolog\u0026iacute;a (English Edition) 2013;28(4):236-249. (10.1016/j.nrleng.2011.03.011). DOI: 10.1016/j.nrleng.2011.03.011.\u003c/li\u003e\n\u003cli\u003eMcGurgan IJ, Ziai WC, Werring DJ, Salman RA-S, Parry-Jones AR. Acute intracerebral haemorrhage: diagnosis and management. Practical Neurology 2021;21(2):128-136. DOI: 10.1136/practneurol-2020-002763.\u003c/li\u003e\n\u003cli\u003eWolfe CD, Taub NA, Woodrow EJ, Burney PG. Assessment of scales of disability and handicap for stroke patients. Stroke 1991;22(10):1242-4. DOI: 10.1161/01.str.22.10.1242.\u003c/li\u003e\n\u003cli\u003eSaver JL, Chaisinanunkul N, Campbell BCV, et al. Standardized Nomenclature for Modified Rankin Scale Global Disability Outcomes: Consensus Recommendations From Stroke Therapy Academic Industry Roundtable XI. Stroke 2021;52(9):3054-3062. DOI: 10.1161/STROKEAHA.121.034480.\u003c/li\u003e\n\u003cli\u003eBroderick JP, Adeoye O, Elm J. Evolution of the Modified Rankin Scale and Its Use in Future Stroke Trials. Stroke 2017;48(7):2007-2012. DOI: 10.1161/STROKEAHA.117.017866.\u003c/li\u003e\n\u003cli\u003eChien SC, Tu PH, Liu ZH, et al. Neurological deteriorations in mild brain injuries: the strategy of evaluation and management. Eur J Trauma Emerg Surg 2022;48(3):2173-2181. DOI: 10.1007/s00068-021-01753-6.\u003c/li\u003e\n\u003cli\u003eChien SC, Kang SC, Tu PH, et al. Nuance and profound impact: Evaluating the effects of the unmet full coma scale in patients with mild subdural hemorrhage. Am J Emerg Med 2024;77:60-65. DOI: 10.1016/j.ajem.2023.11.038.\u003c/li\u003e\n\u003cli\u003eFeldman EA, Meola G, Zyck S, et al. Retrospective Assessment of Desmopressin Effectiveness and Safety in Patients With Antiplatelet-Associated Intracranial Hemorrhage. Crit Care Med 2019;47(12):1759-1765. DOI: 10.1097/CCM.0000000000004021.\u003c/li\u003e\n\u003cli\u003eBarletta JF, Abdul-Rahman D, Hall ST, et al. The Role of Desmopressin on Hematoma Expansion in Patients with Mild Traumatic Brain Injury Prescribed Pre-injury Antiplatelet Medications. Neurocritical Care 2020;33(2):405-413. DOI: 10.1007/s12028-019-00899-x.\u003c/li\u003e\n\u003cli\u003eSchmidt KJ, Sager B, Zachariah J, Raad BF, James EG, Fletcher JJ. Cohort analysis of desmopressin effect on hematoma expansion in patients with spontaneous intracerebral hemorrhage and documented pre-ictus antiplatelet use. J Clin Neurosci 2019;66:33-37. DOI: 10.1016/j.jocn.2019.05.032.\u003c/li\u003e\n\u003cli\u003eKim JH, Baek CH, Min JY, Kim J-S, Kim SB, Kim H. Desmopressin improves platelet function in uremic patients taking antiplatelet agents who require emergent invasive procedures. Annals of Hematology 2015;94(9):1457-1461. DOI: 10.1007/s00277-015-2384-1.\u003c/li\u003e\n\u003cli\u003eBaharoglu MI, Cordonnier C, Al-Shahi Salman R, et al. Platelet transfusion versus standard care after acute stroke due to spontaneous cerebral haemorrhage associated with antiplatelet therapy (PATCH): a randomised, open-label, phase 3 trial. Lancet 2016;387(10038):2605-2613. DOI: 10.1016/S0140-6736(16)30392-0.\u003c/li\u003e\n\u003cli\u003eLi X, Sun Z, Zhao W, et al. Effect of acetylsalicylic acid usage and platelet transfusion on postoperative hemorrhage and activities of daily living in patients with acute intracerebral hemorrhage. J Neurosurg 2013;118(1):94-103. DOI: 10.3171/2012.9.JNS112286.\u003c/li\u003e\n\u003cli\u003eFrancoeur CL, Roh D, Schmidt JM, et al. Desmopressin administration and rebleeding in subarachnoid hemorrhage: analysis of an observational prospective database. Journal of Neurosurgery 2019;130(2):502-508. DOI: 10.3171/2017.7.jns17990.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1. Baseline Characteristics of the overall population before and after inverse probability of treatment weighting\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"896\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.48603351955307%\"\u003e\n \u003cp\u003eCharacteristics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.620111731843576%\" colspan=\"3\"\u003e\n \u003cp\u003eBefore IPTW\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.58659217877095%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.94413407821229%\" colspan=\"3\"\u003e\n \u003cp\u003eAfter IPTW (pseudo-population)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.363128491620111%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\"\u003e\u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003eDDAVP\u003c/p\u003e\n \u003cp\u003eN = 26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003eControl\u003c/p\u003e\n \u003cp\u003eN = 49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e\u003cem\u003eP\u0026nbsp;\u003c/em\u003evalue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\"\u003e\n \u003cp\u003eASMD\u003csup\u003e\u0026dagger;\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003eDDAVP\u003c/p\u003e\n \u003cp\u003eN = 69.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003eControl\u003c/p\u003e\n \u003cp\u003eN = 72.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e\u003cem\u003eP\u0026nbsp;\u003c/em\u003evalue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\"\u003e\n \u003cp\u003eASMD\u003csup\u003e\u0026dagger;\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\" valign=\"top\"\u003e\n \u003cp\u003eAge (years), median [IQR]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\" valign=\"top\"\u003e\n \u003cp\u003e71.0 [64.0-79.8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\" valign=\"top\"\u003e\n \u003cp\u003e67.0 [57.0-79.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e0.497\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\"\u003e\n \u003cp\u003e0.108\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e68.0 [57.9-78.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e67.0 [55.4-78.8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e0.577\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\"\u003e\n \u003cp\u003e0.135\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\" valign=\"top\"\u003e\n \u003cp\u003eMale, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e19 (73.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e37 (75.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\"\u003e\n \u003cp\u003e0.056\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e48.7 (69.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e55.1 (76.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e0.640\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\"\u003e\n \u003cp\u003e0.144\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\" valign=\"top\"\u003e\n \u003cp\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e), mean \u0026plusmn; SD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e24.6 \u0026plusmn; 3.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e25.6 \u0026plusmn; 3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e0.250\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\" valign=\"top\"\u003e\n \u003cp\u003e0.276\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e24.5 \u0026plusmn; 3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e25.3 \u0026plusmn; 3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e0.379\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\"\u003e\n \u003cp\u003e0.227\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\" valign=\"top\"\u003e\n \u003cp\u003eSystolic blood pressure (mmHg), mean \u0026plusmn; SD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e183.6 \u0026plusmn; 33.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e167.6 \u0026plusmn; 44.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e0.112\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\" valign=\"top\"\u003e\n \u003cp\u003e0.408\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e179.0 \u0026plusmn; 33.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e175.5 \u0026plusmn; 47.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e0.744\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\"\u003e\n \u003cp\u003e0.087\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\" valign=\"top\"\u003e\n \u003cp\u003eMedian GCS score, mean \u0026plusmn; SD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e9.0 \u0026plusmn; 3.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e8.7 \u0026plusmn; 3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e0.701\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\" valign=\"top\"\u003e\n \u003cp\u003e0.094\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e9.1 \u0026plusmn; 3.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e8.4 \u0026plusmn; 3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e0.532\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\"\u003e\n \u003cp\u003e0.196\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\"\u003e\n \u003cp\u003ePast medical history, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\" valign=\"top\"\u003e\n \u003cp\u003eHypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e22 (84.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e44 (89.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e0.711\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\"\u003e\n \u003cp\u003e0.156\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e63.8 (91.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e65.7 (90.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e0.909\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\"\u003e\n \u003cp\u003e0.025\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\" valign=\"top\"\u003e\n \u003cp\u003eDiabetes mellitus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e11 (42.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e23 (46.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e0.889\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\"\u003e\n \u003cp\u003e0.093\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e22.2 (31.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e30.4 (41.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e0.442\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\"\u003e\n \u003cp\u003e0.213\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\" valign=\"top\"\u003e\n \u003cp\u003eCoronary artery disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e6 (23.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e18 (36.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e0.344\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\"\u003e\n \u003cp\u003e0.302\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e13.4 (19.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e22.2 (30.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e0.327\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\"\u003e\n \u003cp\u003e0.266\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\" valign=\"top\"\u003e\n \u003cp\u003eChronic kidney disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e4 (15.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e7 (14.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\"\u003e\n \u003cp\u003e0.031\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e17.2 (24.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e14.3 (19.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e0.732\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\"\u003e\n \u003cp\u003e0.120\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\" valign=\"top\"\u003e\n \u003cp\u003ePrior ischemic stroke\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e16 (61.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e31 (63.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\"\u003e\n \u003cp\u003e0.036\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e48.2 (69.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e44.6 (61.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e0.585\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\"\u003e\n \u003cp\u003e0.159\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\" valign=\"top\"\u003e\n \u003cp\u003ePeripheral artery disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e2 (4.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e0.541\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\" valign=\"top\"\u003e\n \u003cp\u003e0.292\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e0.0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e3.0 (4.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e0.174\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\" valign=\"top\"\u003e\n \u003cp\u003e0.293\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\"\u003e\n \u003cp\u003ePrior antiplatelet therapy, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e0.147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\" valign=\"top\"\u003e\n \u003cp\u003e0.490\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e0.937\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\"\u003e\n \u003cp\u003e0.106\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\"\u003e\n \u003cp\u003eAspirin alone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e23 (88.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e38 (77.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e55.0 (78.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e58.1 (80.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\"\u003e\n \u003cp\u003eClopidogrel alone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e1 (3.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e9 (18.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e9.6 (13.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e10.8 (14.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\"\u003e\n \u003cp\u003eAspirin and Clopidogrel\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e2 (7.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e2 (4.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e5.3 (7.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e3.7 (5.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\"\u003e\n \u003cp\u003ePreoperative platelet transfusion, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e18 (69.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e15 (30.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\"\u003e\n \u003cp\u003e0.837\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e51.5 (73.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e24.4 (33.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e0.007\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\"\u003e\n \u003cp\u003e0.876\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\"\u003e\n \u003cp\u003ePreoperative tranexamic acid\u0026nbsp;use, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e12 (46.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e22 (44.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\"\u003e\n \u003cp\u003e0.025\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e27.5 (39.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e33.9 (46.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e0.614\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\"\u003e\n \u003cp\u003e0.150\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\" valign=\"top\"\u003e\n \u003cp\u003eLaboratory data\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\" valign=\"top\"\u003e\n \u003cp\u003eHemoglobin (g/dL), mean \u0026plusmn; SD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e13.3 \u0026plusmn; 2.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e13.8 \u0026plusmn; 1.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e0.311\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\"\u003e\n \u003cp\u003e0.243\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e13.4 \u0026plusmn; 2.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e13.8 \u0026plusmn; 1.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e0.637\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\"\u003e\n \u003cp\u003e0.165\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\" valign=\"top\"\u003e\n \u003cp\u003ePlatelet (10\u003csup\u003e3\u003c/sup\u003e/uL), mean \u0026plusmn; SD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e217 \u0026plusmn; 64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e231 \u0026plusmn; 59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e0.346\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\"\u003e\n \u003cp\u003e0.227\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e225 \u0026plusmn; 51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e226 \u0026plusmn; 59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e0.944\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\"\u003e\n \u003cp\u003e0.016\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\" valign=\"top\"\u003e\n \u003cp\u003eINR, median [IQR]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e1.0 [1.0-1.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e1.0 [1.0-1.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e0.271\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\"\u003e\n \u003cp\u003e0.297\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e1.0 [1.0, 1.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e1.0 [1.0, 1.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e0.197\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\"\u003e\n \u003cp\u003e0.304\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\" valign=\"top\"\u003e\n \u003cp\u003eSodium (mEq/L), mean \u0026plusmn; SD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e139 \u0026plusmn; 4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e137 \u0026plusmn; 3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e0.038\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\"\u003e\n \u003cp\u003e0.486\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e137 \u0026plusmn; 4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e137 \u0026plusmn; 3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e0.783\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\"\u003e\n \u003cp\u003e0.087\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\"\u003e\n \u003cp\u003eICH location, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e0.900\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\" valign=\"top\"\u003e\n \u003cp\u003e0.103\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e0.982\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\"\u003e\n \u003cp\u003e0.053\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\"\u003e\n \u003cp\u003eSupratentorial deep\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e13 (50.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e27 (55.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e36.1 (51.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e37.1 (51.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\"\u003e\n \u003cp\u003eSupratentorial lobar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e6 (23.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e10 (20.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e13.1 (18.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e15.1 (20.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\"\u003e\n \u003cp\u003eInfratentorial\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e7 (26.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e12 (24.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e20.7 (29.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e20.4 (28.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\"\u003e\n \u003cp\u003eICH etiology, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e0.958\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\" valign=\"top\"\u003e\n \u003cp\u003e0.150\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e0.926\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\"\u003e\n \u003cp\u003e0.162\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\"\u003e\n \u003cp\u003eHypertensive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e20 (76.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e38 (77.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e56.4 (80.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e56.4 (77.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\"\u003e\n \u003cp\u003eCerebral amyloid angiopathy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e3 (11.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e4 (8.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e7.4 (10.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e6.8 (9.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\"\u003e\n \u003cp\u003eHemorrhagic transformation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e2 (7.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e4 (8.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e4.6 (6.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e5.9 (8.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\"\u003e\n \u003cp\u003eCryptogenic atypical ICH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e1 (3.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e3 (6.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e1.5 (2.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e3.5 (4.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\"\u003e\n \u003cp\u003eICH volume, median [IQR]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e40.0 [19.9-60.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e31.0 [16.5-61.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e0.593\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\" valign=\"top\"\u003e\n \u003cp\u003e0.152\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e30.0 [10.0-59.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e31.0 [16.6-60.9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e0.567\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\"\u003e\n \u003cp\u003e0.075\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\"\u003e\n \u003cp\u003eTotal ICH score, median [IQR]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e3.0 [2.0-3.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e2.0 [2.0-3.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e0.270\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\" valign=\"top\"\u003e\n \u003cp\u003e0.233\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e3.0 [2.0-3.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e3.0 [2.0-3.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e0.982\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\"\u003e\n \u003cp\u003e0.075\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\"\u003e\n \u003cp\u003eAge \u0026gt; 80 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e7 (26.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e8 (16.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e11.6 (16.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e11.5 (15.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\"\u003e\n \u003cp\u003eGCS score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\"\u003e\n \u003cp\u003e13-15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e5 (19.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e9 (18.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e16.4 (23.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e12.1 (16.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\"\u003e\n \u003cp\u003e5-12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e20 (76.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e37 (75.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e50.4 (72.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e52.9 (72.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\"\u003e\n \u003cp\u003e3-4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e1 (3.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e3 (6.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e3.1 (4.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e7.5 (10.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\"\u003e\n \u003cp\u003eICH volume\u0026gt;30 ml\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e15 (57.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e25 (51.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e33.0 (47.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e38.8 (53.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\"\u003e\n \u003cp\u003eIntraventricular extension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e20 (76.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e36 (73.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e59.2 (84.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e54.7 (75.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\"\u003e\n \u003cp\u003eInfratentorial ICH location\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e7 (26.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e12 (24.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e20.7 (29.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e20.4 (28.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\"\u003e\n \u003cp\u003eOperative intervention, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e0.960\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\" valign=\"top\"\u003e\n \u003cp\u003e0.072\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e0.274\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\"\u003e\n \u003cp\u003e0.330\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\"\u003e\n \u003cp\u003eCraniotomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e15 (57.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cpre\u003e30 (61.2)\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e33.6 (48.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e46.6 (64.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.455357142857142%\"\u003e\n \u003cp\u003eExternal ventricular drain only\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.611607142857142%\"\u003e\n \u003cp\u003e11 (42.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.727678571428571%\"\u003e\n \u003cp\u003e19 (38.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.245535714285714%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580357142857143%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.830357142857142%\"\u003e\n \u003cp\u003e36.4 (52.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.160714285714286%\"\u003e\n \u003cp\u003e26.0 (35.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.03125%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.357142857142857%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"9\"\u003e\n \u003cp\u003eIPTW: inverse probability of treatment weighting; DDAVP: desmopressin acetate; ASMD: absolute standardized mean difference; BMI: body mass index; IQR: interquartile range; SD: standard deviation; GCS: Glasgow Coma Scale; INR: international normalized ratio; ICH: intracerebral hemorrhage.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026dagger;Values greater than 0.1 indicate a nonnegligible difference between the two groups.\u003c/p\u003e\n \u003cp\u003e*\u003cem\u003eP\u003c/em\u003e value \u0026lt; 0.05.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2. Comparison of Perioperative records and clinical outcomes before and after inverse probability of treatment weighting\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"820\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\"\u003e\n \u003cp\u003eClinical outcomes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.31013431013431%\" colspan=\"3\"\u003e\n \u003cp\u003eBefore IPTW\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.55433455433455%\" colspan=\"3\"\u003e\n \u003cp\u003eAfter IPTW (pseudo-population)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\"\u003e\u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003eDDAVP\u003c/p\u003e\n \u003cp\u003eN = 26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003eControl\u003c/p\u003e\n \u003cp\u003eN = 49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e\u003cem\u003eP\u0026nbsp;\u003c/em\u003evalue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041514041514041%\"\u003e\n \u003cp\u003eDDAVP\u003c/p\u003e\n \u003cp\u003eN = 69.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003eControl\u003c/p\u003e\n \u003cp\u003eN = 72.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e\u003cem\u003eP\u0026nbsp;\u003c/em\u003evalue\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\" valign=\"top\"\u003e\n \u003cp\u003ePerioperative records\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\u003c/td\u003e\n \u003ctd width=\"14.041514041514041%\"\u003e\u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\" valign=\"top\"\u003e\n \u003cp\u003eIntraoperative bleeding volume (ml), median [IQR]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e100 [10-200]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e200 [15-400]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.316\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041514041514041%\"\u003e\n \u003cp\u003e20 [10-215]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e200 [17-505]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.200\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\"\u003e\n \u003cp\u003eSurgical evacuation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e200 [125-500]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e300 [200-600]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.169\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041514041514041%\"\u003e\n \u003cp\u003e253 [115-500]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e364 [200-600]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.609\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\"\u003e\n \u003cp\u003eExternal ventricular drain only\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e10 [10-10]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e20 [10-20]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.655\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041514041514041%\"\u003e\n \u003cp\u003e10 [10-10]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e10 [8-20]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.286\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\" valign=\"top\"\u003e\n \u003cp\u003eBlood transfusion volume (ml), median [IQR]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e0 [0-293]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e0 [0-564]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.305\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041514041514041%\"\u003e\n \u003cp\u003e0 [0-250]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e76 [0-588]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.288\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\"\u003e\n \u003cp\u003eSurgical evacuation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e210 [0-652]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e422 [0-791]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.482\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041514041514041%\"\u003e\n \u003cp\u003e276 [0-763]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e500 [0-848]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.970\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\"\u003e\n \u003cp\u003eExternal ventricular drain only\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e0 [0-0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e0 [0-0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.173\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041514041514041%\"\u003e\n \u003cp\u003e0 [0-0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e0 [0-0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.093\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\" valign=\"top\"\u003e\n \u003cp\u003eOperation time (min), median [IQR]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e133 [74-197]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e170 [94-234]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.295\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041514041514041%\"\u003e\n \u003cp\u003e105 [58-168]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e186 [94-235]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.253\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\"\u003e\n \u003cp\u003eSurgical evacuation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e168 [149-269]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e212 [186-269]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.268\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041514041514041%\"\u003e\n \u003cp\u003e184 [157-329]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e220 [187-269]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.794\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\"\u003e\n \u003cp\u003eExternal ventricular drain only\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e58 [54-93]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e87 [64-96]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.312\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041514041514041%\"\u003e\n \u003cp\u003e72 [56-94]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e80 [58-96]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.963\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\" valign=\"top\"\u003e\n \u003cp\u003eSAE during hospitalization, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\u003c/td\u003e\n \u003ctd width=\"14.041514041514041%\"\u003e\u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\" valign=\"top\"\u003e\n \u003cp\u003eRebleeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e4 (15.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e15 (30.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.244\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041514041514041%\"\u003e\n \u003cp\u003e10.9 (15.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e26.6 (36.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.131\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\" valign=\"top\"\u003e\n \u003cp\u003eNeurologic deterioration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e12 (46.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e21 (42.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.977\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041514041514041%\"\u003e\n \u003cp\u003e29.0 (41.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e30.0 (41.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.995\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\" valign=\"top\"\u003e\n \u003cp\u003eICH enlargement\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e3 (11.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e12 (24.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.234\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041514041514041%\"\u003e\n \u003cp\u003e9.7 (13.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e21.9 (30.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.233\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\"\u003e\n \u003cp\u003eBrain herniation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e4 (15.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e4 (8.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.437\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041514041514041%\"\u003e\n \u003cp\u003e10.7 (15.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e7.1 (9.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.535\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\" valign=\"top\"\u003e\n \u003cp\u003eIntraventricular extension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e3 (11.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e3 (6.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.412\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041514041514041%\"\u003e\n \u003cp\u003e5.0 (7.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e3.6 (5.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.670\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\" valign=\"top\"\u003e\n \u003cp\u003eHydrocephalus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e9 (34.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e12 (24.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.510\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041514041514041%\"\u003e\n \u003cp\u003e14.6 (20.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e17.6 (24.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.748\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\" valign=\"top\"\u003e\n \u003cp\u003eHyponatremia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e1 (3.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e9 (18.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.150\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041514041514041%\"\u003e\n \u003cp\u003e4.2 (5.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e16.1 (22.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.160\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\" valign=\"top\"\u003e\n \u003cp\u003eThromboembolism\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e3 (11.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e2 (4.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.334\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041514041514041%\"\u003e\n \u003cp\u003e6.4 (9.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e4.0 (5.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.584\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\" valign=\"top\"\u003e\n \u003cp\u003eInfection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e17 (65.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e35 (71.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.782\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041514041514041%\"\u003e\n \u003cp\u003e38.1 (54.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e51.7 (71.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.247\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\" valign=\"top\"\u003e\n \u003cp\u003eEpileptic seizures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e8 (30.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e10 (20.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.474\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041514041514041%\"\u003e\n \u003cp\u003e21.0 (30.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e14.0 (19.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.402\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\" valign=\"top\"\u003e\n \u003cp\u003eTransfusion-related adverse events\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e1 (2.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041514041514041%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e2.2 (3.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.325\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\" valign=\"top\"\u003e\n \u003cp\u003eIn-hospital and follow-up outcomes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041514041514041%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\"\u003e\n \u003cp\u003eLength of hospital stay, median [IQR]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e30.0 [23.0-47.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e29.0 [23.0-49.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.854\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041514041514041%\"\u003e\n \u003cp\u003e28.0 [16.4-48.5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e34.0 [23.1-52.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.602\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\"\u003e\n \u003cp\u003eLength of ICU stay, median [IQR]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e11.5 [6.0-27.8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e8.0 [4.0-19.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.155\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041514041514041%\"\u003e\n \u003cp\u003e9.4 [4.3-27.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e8.0 [4.0-21.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.741\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\"\u003e\n \u003cp\u003eIn-hospital mortality, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e5 (19.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e7 (14.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.742\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041514041514041%\"\u003e\n \u003cp\u003e11.9 (17.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e10.1 (13.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.747\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\"\u003e\n \u003cp\u003eReadmission to neurosurgical wards within 30 days, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e1 (2.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041514041514041%\"\u003e\n \u003cp\u003e0.0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e1.2 (1.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.337\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\"\u003e\n \u003cp\u003emRS score at discharge, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041514041514041%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e0.533\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\"\u003e\n \u003cp\u003e0-3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e4 (15.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e8 (16.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041514041514041%\"\u003e\n \u003cp\u003e15.8 (22.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e10.8 (14.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.135531135531135%\"\u003e\n \u003cp\u003e4-6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e22 (84.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e41 (83.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041514041514041%\"\u003e\n \u003cp\u003e54.1 (77.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.797313797313798%\"\u003e\n \u003cp\u003e61.8 (85.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.715506715506716%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"7\"\u003e\n \u003cp\u003eIQR: interquartile range; IPTW: inverse probability of treatment weighting; DDAVP: desmopressin acetate; SAE: serious adverse event; ICH: intracerebral hemorrhage; mRS: modified Rankin Scale\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Intracranial Hemorrhages (ICH), Desmopressin acetate (DDAVP), Antiplatelet Agent, Neurosurgery, Treatment Outcome","lastPublishedDoi":"10.21203/rs.3.rs-4440555/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4440555/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eManaging surgical cases of acute spontaneous intracerebral hemorrhage (ICH) in patients with antiplatelet therapy presents significant challenges due to the heightened risk of bleeding. Desmopressin acetate (DDAVP) is commonly employed as a management strategy. This multi-center study aims to compare the functional and safety outcomes in patients with or without preoperative DDAVP administration after spontaneous antiplatelet-associated ICH.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFrom January 2016 to November 2023, we enrolled patients with spontaneous ICH who were under antiplatelet therapy and needed neurosurgical interventions in the emergency departments. Patients were excluded for traumatic brain injury, ICH from subarachnoid hemorrhage, arteriovenous malformation, intracranial tumors, coagulopathies, and anticoagulant use. The primary outcome was the modified Rankin Scale (mRS) at discharge. Secondary endpoints included safety outcomes, in-hospital and follow-up outcomes.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 75 patients were included, comprising 26 patients treated with DDAVP and 49 patients in the control group. After inverse probability of treatment weighting adjustment, there were no significant differences in baseline characteristics except for preoperative platelet transfusion between the DDAVP and control group (73.6% vs 33.6%; \u003cem\u003ep\u003c/em\u003e = 0.007). There were no significant differences in mRS of 4 – 6 at discharge between groups (77.4% vs 85.1%; \u003cem\u003ep\u003c/em\u003e = 0.533). Multivariable generalized estimating equations logistic regression demonstrated DDAVP was not significantly associated with improved functional outcome, safety outcomes, in-hospital or follow-up outcomes.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study demonstrated that there was no significant difference in mRS at discharge or SAEs between patients with and without DDAVP administration. Further randomized controlled trials are warranted to validate our findings.\u003c/p\u003e","manuscriptTitle":"Impact of Desmopressin on Clinical Outcomes in Patients with Spontaneous Antiplatelet-Associated Intracerebral Hemorrhage Undergoing Neurosurgical Intervention: An Observational Multi-Center Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-06-12 17:37:27","doi":"10.21203/rs.3.rs-4440555/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"aeb5206e-c0bb-4c43-bf4f-248f5fb91397","owner":[],"postedDate":"June 12th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-07-09T21:00:44+00:00","versionOfRecord":[],"versionCreatedAt":"2024-06-12 17:37:27","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4440555","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4440555","identity":"rs-4440555","version":["v1"]},"buildId":"WrCJVZZCHTDjtuVLN7oU0","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}