{"id":15839,"date":"2022-02-02T16:12:15","date_gmt":"2022-02-02T15:12:15","guid":{"rendered":"https:\/\/convergences.online\/hemato\/?p=15839"},"modified":"2024-12-11T14:37:09","modified_gmt":"2024-12-11T13:37:09","slug":"hemorragies-intracerebrales-et-hemophilie","status":"publish","type":"post","link":"https:\/\/www.hematostat.net\/en\/hemorragies-intracerebrales-et-hemophilie\/","title":{"rendered":"H\u00e9morragies intrac\u00e9r\u00e9brales et h\u00e9mophilie"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:calc( 1240px + 0px );margin-left: calc(-0px \/ 2 );margin-right: calc(-0px \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:0px;--awb-margin-bottom-large:0px;--awb-spacing-left-large:0px;--awb-width-medium:100%;--awb-spacing-right-medium:0px;--awb-spacing-left-medium:0px;--awb-width-small:100%;--awb-spacing-right-small:0px;--awb-spacing-left-small:0px;\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-1\"><p>R\u00e9f. : HematoStat.net ; 3 (1) : R40<\/p>\n<p><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/34411236\/\"><em>Anne-Fleur Zwagemaker<\/em><em>and al. Incidence and mortality rates of intracranial hemorrhage in hemophilia: a systematic review and meta-analysis. <\/em><em> <\/em><\/a><\/p>\n<p><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/34411236\/\"><em>Blood. 2021 Dec 30;138(26):2853-2873.doi: 10.1182\/blood.2021011849.<\/em><\/a><\/p>\n<\/p>\n<h3><strong>R\u00e9sum\u00e9 de l&#8217;article <\/strong><\/h3>\n<p>La survenue d\u2019une h\u00e9morragie intrac\u00e9r\u00e9brale (HIC) chez un patient h\u00e9mophile est une complication h\u00e9morragique potentiellement dramatique. Les auteurs ont r\u00e9alis\u00e9 une revue syst\u00e9matique de la litt\u00e9rature ainsi qu\u2019une m\u00e9ta-analyse pour estimer de mani\u00e8re plus pr\u00e9cise l\u2019incidence et la mortalit\u00e9 des HIC dans la population h\u00e9mophile. Trois cohortes d\u2019\u00e2ges diff\u00e9rents ont \u00e9t\u00e9 r\u00e9alis\u00e9es et \u00e9tudi\u00e9es : h\u00e9mophiles de tous \u00e2ges, h\u00e9mophiles de moins de 25 ans et pendant la p\u00e9riode n\u00e9onatale. Les auteurs ont analys\u00e9 45 \u00e9tudes qui repr\u00e9sentaient 54 470 patients, 809 151 patients-ann\u00e9e et 5 326 naissances vivantes de patients atteints d\u2019h\u00e9mophilie. Chez les personnes de tous \u00e2ges, les taux d\u2019incidence et de mortalit\u00e9 de l\u2019ICH regroup\u00e9s \u00e9taient respectivement de 2,3 (intervalle de confiance [IC] \u00e0 95 %, 1,2 \u00e0 4,8) et de 0,8 (IC \u00e0 95 %, 0,5 \u00e0 1,2) par 1 000 patient-ann\u00e9es. Chez les enfants et les jeunes adultes, les taux d\u2019incidence et de mortalit\u00e9 de l\u2019ICH regroup\u00e9s \u00e9taient respectivement de 7,4 (IC \u00e0 95 %, 4,9 \u00e0 11,1) et de 0,5 (IC \u00e0 95 %, 0,3 \u00e0 0,9) par 1000 patient-ann\u00e9es. Chez les nouveau-n\u00e9s, l\u2019incidence cumul\u00e9e de l\u2019ICH \u00e9tait de 2,1 % (IC \u00e0 95 %, 1,5-2,8) pour 100 naissances vivantes. L\u2019ICH a \u00e9t\u00e9 class\u00e9e comme spontan\u00e9e dans 35 % \u00e0 58 % des cas.<\/p>\n<h3><strong>Dans nos pratiques <\/strong><\/h3>\n<p>Ces donn\u00e9es sont int\u00e9ressantes pour tous les praticiens et personnels de sant\u00e9 impliqu\u00e9s dans la prise en charge de l\u2019h\u00e9mophilie. Elles d\u00e9montrent que l\u2019h\u00e9morragie c\u00e9r\u00e9brale est un probl\u00e8me important dans la population h\u00e9mophile. C\u2019est une complication qui peut survenir \u00e0 tout \u00e2ge et qui n\u00e9cessite des mesures pr\u00e9ventives adapt\u00e9es. Les nombreuses options th\u00e9rapeutiques dor\u00e9navant disponibles (pour l\u2019h\u00e9mophilie A notamment) permettent de limiter le risque mais l\u2019utilisation des th\u00e9rapeutiques dites non substitutives doit \u00eatre \u00e9valu\u00e9es dans cette indications et dans toutes les cat\u00e9gories d\u2019\u00e2ge.<\/p>\n<h3><strong>Le regard du statisticien<\/strong><\/h3>\n<p>La revue syst\u00e9mique a scrupuleusement suivi les recommandations de PRISMA (<em>Preferred Reporting Items for Systematic Reviews and Meta-Analysis<\/em>), qui suit un processus aussi fiable et rigoureux que les standards de Cochrane. De plus les auteurs ont utilis\u00e9 des formes de r\u00e9gressions mixtes plus adapt\u00e9s \u00e0 leurs mod\u00e9lisations. Le r\u00e9sum\u00e9 des 45 publications couvrant presque 50 ans d\u2019\u00e9tudes ont bien \u00e9t\u00e9 r\u00e9sum\u00e9es en 2 tables. Belle revue, tr\u00e8s propre.<\/p>\n<\/div><\/div><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":2,"featured_media":15840,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[36],"tags":[270,271,272],"ppma_author":[442],"class_list":["post-15839","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-revue-de-presse","tag-accident-vasculaire-cerebral","tag-hemophilie","tag-hemorragie-intracranienne","author-marion"],"aioseo_notices":[],"authors":[{"term_id":442,"user_id":2,"is_guest":0,"slug":"marion","display_name":"HematoStat.net (M)","avatar_url":{"url":"https:\/\/www.hematostat.net\/wp-content\/uploads\/2024\/01\/favicon-hematoStat.png","url2x":"https:\/\/www.hematostat.net\/wp-content\/uploads\/2024\/01\/favicon-hematoStat.png"},"first_name":"HematoStat.net (M)","last_name":"","user_url":"","description":""}],"_links":{"self":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/15839","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/comments?post=15839"}],"version-history":[{"count":1,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/15839\/revisions"}],"predecessor-version":[{"id":18209,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/15839\/revisions\/18209"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/"}],"wp:attachment":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/media?parent=15839"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/categories?post=15839"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/tags?post=15839"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/ppma_author?post=15839"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}