Abstract Number: PB0610
Meeting: ISTH 2021 Congress
Background: Intracranial hemorrhage (ICH) is one of the life-threatening bleeding events in hemophiliac patients resulting in high mortality rate and neurological sequelae. Although the guideline of treatment of hemophiliac patients with ICH is established, the management of hemophiliac patients with ICH in the developing countries is challenging.
Aims: To determine prevalence and outcome following treatment of ICH in hemophilia patients at Chiang Mai University (CMU) Hospital.
Methods: This study retrospectively reviewed ICH among hemophilic patients at CMU Hospital over a period of 10 years (2009–2019).
Results: Nine patients (six with hemophilia A and three with hemophilia B) with 14 events of ICH from a total of 105 hemophiliac patients were enrolled. The prevalence of nine percent of hemophiliac patients. Eight of 14 events were reportedly traumatic. Five ICH events in three patients [36 and 33% of events and patients, respectively] were took care under Department of Pediatrics. One patient had significant inhibitor prior to the ICH event while one patient was treated with secondary low-dose prophylaxis. Two events of ICH were treated with factor concentrates alone, while other 12 events were treated with blood components, including cryoprecipitate or fresh frozen plasma or combined with factor concentrates including recombinant activated factor VII in the patient with inhibitor. Only one adult patient with ICH passed away despite receiving replacement therapy and surgical intervention resulting in the mortality rate at 11% in this cohort. Median total factor replacement (combination of various products) in hemophilia A and hemophilia B were 721 and 945 unit/kg/event, respectively. Only two pediatric patients had been treated with secondary prophylaxis treatment after acute events.
Despite proper replacement therapy with the limited resources and surgical intervention, ICH was still the emergency bleeding events with high mortality rate among hemophiliac patients in this cohort especially in those who had treated with on demand treatment.
To cite this abstract in AMA style:Khamyuang J, Charoenkwan P, Satitsamitpong L, Sittipreechacharn S, Chai-Adisaksopha C, Natesirinilkul R. Intracranial Hemorrhage in Hemophiliac Patients at Chiang Mai University Hospital: A 10-year Retrospective Study [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 1). https://abstracts.isth.org/abstract/intracranial-hemorrhage-in-hemophiliac-patients-at-chiang-mai-university-hospital-a-10-year-retrospective-study/. Accessed September 24, 2021.
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