Does warfarin-related intracerebral haemorrhage lead to higher costs of management?
BACKGROUND AND PURPOSE
Warfarin-related intracerebral haemorrhage is associated with significant morbidity but long term treatment costs are unknown. Our study aimed to assess the cost of warfarin-related intracerebral haemorrhage.


METHODS
We included all patients with intracerebral haemorrhage between July 2006 and December 2011 at a single centre. We collected data on anticoagulant use, baseline clinical variables, discharge destinations, modified Rankin Scale at discharge and in-hospital costings. First year costings were extracted from previous studies. Multiple linear regression for treatment cost was performed with stratified analysis to assess for effect modification.


RESULTS
There were 694 intracerebral haemorrhage patients, with 108 (15.6%) previously on warfarin. Mean age (SD) of participants was 70.3 (13.6) and 58.5% were male. Patients on warfarin compared to those not on warfarin had significantly lower rates of discharge home (12.0% versus 18.9%, p=0.013). Overall total costs between groups were similar, $AUD 25,767 for warfarin-related intracerebral haemorrhage and $AUD 27,388 for non-warfarin intracerebral haemorrhage (p=0.353). Stratified analysis showed survivors of warfarin-related intracerebral haemorrhage had higher costs compared to those without warfarin ($AUD 33,419 versus $AUD 30,193, p<0.001) as well as increased length of stay (12 days versus 8 days, p<0.001). Inpatient mortality of patients on warfarin was associated with a shorter length of stay (p=0.001) and lower costs.


CONCLUSION
Survival of initial haemorrhage on warfarin was associated with increased treatment cost and length of stay but this was discounted by higher rates and earlier nature of mortality in warfarinised patients.
['Kam|Jeremy K|JK|', 'Chen|Zhibin|Z|', 'Liew|Danny|D|', 'Yan|Bernard|B|']
D000368:Aged D000369:Aged, 80 and over D000925:Anticoagulants D002543:Cerebral Hemorrhage D005260:Female D017721:Hospital Costs D017052:Hospital Mortality D006760:Hospitalization D006801:Humans D008297:Male D008875:Middle Aged D014859:Warfarin
Intracerebral haemorrhage Cost Warfarin Mortality Stroke