Influence Of Prior Aspirin On Hematoma Volume And Hematoma Growth In Spontaneous Intracerebral Hemorrhage Patients

Objective To explore the effect of aspirin on elderly patients with spontaneous intracerebral hemorrhage and to provide reference for clinical drug use by observing the progress of baseline blood loss and bleeding volume of patients with cerebral hemorrhage in the acute phase of cerebral hemorrhage with low dose aspirin.Methods The medical records of 105 elderly patients with spontaneous intracerebral hemorrhage within six hours in the sixth and eighth Medical Center of PLA General Hospital from January 1,2015 to July 31,2021 were collected retrospectively.According to the previous use of aspirin,the patients were divided into two groups:preventive aspirin group(n=31)and non-preventive aspirin group(n=74).Collect sex,age,aspirin use,regular and timely growth of aspirin use,admission systolic blood pressure,admission diastolic blood pressure,admission blood glucose,systolic blood pressure control after admission,hypertension history,diabetes history,coronary atherosclerotic heart disease history,myocardial infarction history,ischemic stroke history,smoking history,alcohol abuse history,admission Glasgow coma score,information such as modified Rankin score at 1 month after onset.The CT data of patients with cerebral hemorrhage within 6 hours and within 6-72 hours were collected and divided into 24 hours.The amount of bleeding was calculated by software(FIREVOXEL software)and the shape of hematoma was judged manually(Barras scale).The difference of bleeding volume,bleeding progress and hematoma shape between the two groups were compared.Results There was no significant difference in the amount of bleeding and the increase of bleeding between the elderly patients with regular preventive use of low-dose aspirin and those without preventive use of aspirin,but there was a significant increase in the proportion of bleeding ≥45cm3 in the group of preventive use of aspirin at the second CT scan(χ2=4.131,P=0.042<0.05).The proportion of irregular bleeding during the first CT scan in the preventive aspirin group was significantly higher than that in the non-preventive aspirin group(χ2=6.723,P=0.01<0.05).Conclusion Compared with patients without preventive use of aspirin,regular preventive use of low-dose aspirin may lead to the trend of increase in the amount of cerebral hemorrhage,although there is no significant difference in absolute and relative increase between the two groups.However,the results suggest that the preventive use of aspirin may increase the proportion of patients with massive hemorrhage(≥45cm3)and irregular bleeding more easily,and the results of the two groups are statistically significant.These suggest that the preventive use of aspirin may lead to a further increase in the amount of bleeding in patients with acute cerebral hemorrhage.