ABO Blood Type and Thromboembolic Complications after Intracerebral Hemorrhage: an exploratory analysis

Natasha Ironside; Kara Melmed; Ching-Jen Chen; Setareh Omran; Soojin Park; Sachin Agarwal; E Sander Connolly; Jan Claassen; Eldad A Hod; David Roh

doi:10.21203/rs.3.rs-3108135/v1

ABO Blood Type and Thromboembolic Complications after Intracerebral Hemorrhage: an exploratory analysis

Res Sq [Preprint]. 2023 Jul 27:rs.3.rs-3108135. doi: 10.21203/rs.3.rs-3108135/v1.

Authors

Natasha Ironside¹, Kara Melmed², Ching-Jen Chen³, Setareh Omran⁴, Soojin Park⁵, Sachin Agarwal⁶, E Sander Connolly⁷, Jan Claassen⁵, Eldad A Hod⁸, David Roh⁷

Affiliations

¹ University of Virginia.
² New York University Grossman School of Medicine.
³ University of Texas Health Science Center at Houston School of Dentistry: The University of Texas Health Science Center at Houston School of Dentistry.
⁴ Oregon Health & Science University Neurological Sciences Institute: Oregon Health & Science University Brain Institute.
⁵ Columbia University Medical Center: Columbia University Irving Medical Center.
⁶ CUMC: Columbia University Irving Medical Center.
⁷ Columbia University Irving Medical Center.
⁸ CUIMC: Columbia University Irving Medical Center.

Abstract

Background and purpose: Non-O blood types are known to be associated with thromboembolic complications (TECs) in population-based studies. TECs are known drivers of morbidity and mortality in intracerebral hemorrhage (ICH) patients, yet the relationships of blood type on TECs in this patient population are unknown. We sought to explore the relationships between ABO blood type and TECs in ICH patients.

Methods: Consecutive adult ICH patients enrolled into a prospective observational cohort study with available ABO blood type data were analyzed. Patients with cancer history, prior thromboembolism, and baseline laboratory evidence of coagulopathy were excluded. The primary exposure variable was blood type (non-O versus O). The primary outcome was composite TEC, defined as pulmonary embolism, deep venous thrombosis, ischemic stroke or myocardial infarction, during the hospital stay. Relationships between blood type, TECs and clinical outcomes were separately assessed using logistic regression models after adjusting for sex, ethnicity and ICH score.

Results: Of 301 ICH patients included for analysis, 44% were non-O blood type. Non-O blood type was associated with higher admission GCS and lower ICH score on baseline comparisons. We identified TECs in 11.6% of our overall patient cohort. Although TECs were identified in 9.9% of non-O blood type patients compared to 13.0% in O blood type patients, we did not identify a significant relationship of non-O blood type with TECs (adjusted OR = 0.776, 95%CI: 0.348-1.733, p = 0.537). The prevalence of specific TECs were also comparable in unadjusted and adjusted analyses between the two cohorts. In additional analyses, we identified that TECs were associated with poor 90-day mRS (adjusted OR = 3.452, 95% CI: 1.001-11.903, p = 0.050). We did not identify relationships between ABO blood type and poor 90-day mRS (adjusted OR = 0.994, 95% CI:0.465-2.128, p = 0.988).

Conclusions: We identified that TECs were associated with worse ICH outcomes. However, we did not identify relationships in ABO blood type and TECs. Further work is required to assess best diagnostic and prophylactic and treatment strategies for TECs to improve ICH outcomes.

Keywords: ABO blood type; intracerebral hemorrhage; thromboembolism.

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Abstract

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