The risk of delayed intracranial hemorrhage with direct acting oral anticoagulants after trauma: A two-center study - 24/05/19
, Leslie Kobayashi b, Navpreet K. Dhillon a, Kavita A. Patel a, Eric J. Ley a, Raul Coimbra b, Daniel R. Margulies aAbstract |
Background |
The aim of this study was to characterize the risk of a delayed intracranial hemorrhage (ICH) in trauma patients on direct-acting oral anticoagulants (DOACs).
Methods |
Patients on DOACs admitted to two Level I Trauma Centers between 2014 and 2017 were reviewed. Only patients with a negative admission CT brain were included. The primary outcome was a delayed ICH.
Results |
Overall, 249 patients were included. The median age was 81 years with 82% undergoing a repeat CT. Three patients developed a delayed ICH (1.2%). One developed an ICH after receiving tissue plasminogen activator for a cerebrovascular accident after two negative CTs. Excluding this patient, the incidence dropped to 0.8%. None required neurosurgical intervention.
Conclusion |
For patients at risk for a TBI who are on DOACs, repeat cross-sectional imaging of the brain when the initial imaging is negative is not necessary. A period of clinical observation may be warranted.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Risk of delayed intracranial bleed unknown with direct-acting oral anticoagulants. |
• | Patients were reviewed for presence of delayed intracranial hemorrhage. |
• | Only 1.2% of these patients developed a delayed intracranial hemorrhage. |
• | Repeat imaging of the brain may be unnecessary if initial is negative. |
Keywords : Oral anticoagulants, Delayed intracranial hemorrhage, Traumatic brain injury, NOACs, DOACs
Plan
Vol 217 - N° 6
P. 1051-1054 - juin 2019 Retour au numéro
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