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Abstract Details

Stroke in Cancer Patients
Neuro-oncology
P2 - Poster Session 2 (8:00 AM-9:00 AM)
13-013

The aim of this study is to assess the use of anticoagulation in cancer patients who suffered a stroke. 
Patients with malignancy have an increased tendency for venous and arterial embolism, and for increased risk for bleeding. Clinical decision regarding anticoagulation in this population has been challenging and complicated by the availability of various anticoagulant therapies. Currently, there is no evidence-based guideline available for the prevention of arterial embolism and thrombosis, such as stroke, in cancer patients. 
ICD-9/-10 codes were used to identify patients with cancer who were admitted between September 1, 2017 and November 30, 2017 to the Buffalo General Hospital with the diagnosis of stroke. Chart review was conducted to verify the history of cancer and stroke, and to collect additional information. 
The diagnosis of acute stroke and cancer were verified in 87 patients. Among them, 31 patients had active malignancy. Of the 31 patients, 9 were diagnosed with intracranial hemorrhage and 22 with ischemic strokes. Of the 9 patients with intracranial hemorrhage, 3 were anticoagulated and 1 patient was off anticoagulation. Of the 22 patients with ischemic stroke, 4 patients were anticoagulated, although 1 patient had subtherapeutic INR on coumadin. Seven of the 22 patients were taken off of anticoagulation; 3 had side effects and 4 were awaiting a surgical procedure. Five of the 9 patients with intracranial hemorrhage and 10 of the 22 patients with ischemic stroke were made comfort care and passed away shortly after the diagnosis of stroke. 

Stroke in patients with active cancer resulted in approximately 50% mortality. In order to improve medical prevention for stroke, more studies are needed to better identify and stratify cancer patients with risk factors for ischemic versus hemorrhagic stroke and to review the value of the different anticoagulation therapies in this patient population.
Authors/Disclosures
Marilou I. Ching, MD (Chingbingyong)
PRESENTER 		Dr. Ching has nothing to disclose.
Edina Komlodi-Pasztor, MD, PhD Dr. Komlodi-Pasztor has nothing to disclose.