Not all traumatic brain injury patients on preinjury anticoagulation are the same - 22/11/23
, Qaidar Alizai , Christina Colosimo , Audrey L. Spencer , Collin Stewart , Adam Nelson , Michael Ditillo , Lourdes Castanon , Louis J. Magnotti , Bellal Joseph ⁎ , BIG Multi-institutional Study Group
The American Association for the Surgery of Trauma Brain Injury Guidelines Multi-institutional Study Group
Linda Dultz, George Black, Marc Campbell, Allison E. Berndtson, Todd Costantini, Andrew Kerwin, David Skarupa, Sigrid Burruss, Lauren Delgado, Mario Gomez, Dalier R. Mederos, Robert Winfield, Daniel Cullinane, Hamidreza HosseinpourAbstract |
Background |
Prognostic significance of different anticoagulants in TBI patients remains unanswered. We aimed to compare effects of different anticoagulants on outcomes of TBI patients.
Methods |
A secondary analysis of AAST BIG MIT. Blunt TBI patients ≥50 years using anticoagulants presenting ICH were identified. Outcomes were progression of ICH and need for neurosurgical intervention (NSI).
Results |
393 patients were identified. Mean age was 74 and most common anticoagulant was aspirin (30%), followed by Plavix (28%), and coumadin (20%). 20% had progression of ICH and 10% underwent NSI. On multivariate regression for ICH progression, warfarin, SDH, IPH, SAH, alcohol intoxication and neurologic exam deterioration were associated with increased odds. Warfarin, abnormal neurologic exam on presentation, and SDH were independent predictors of NSI.
Conclusions |
Our findings reflect a dynamic interaction between type of anticoagulants, bleeding pattern & outcomes. Future modifications of BIG may need to take the type of anticoagulant into consideration.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Warfarin use is linked to increased hemorrhage progression and neurosurgical intervention requirement. |
• | Warfarin use is linked to almost three times the mortality. |
• | SDH & abnormal neurological exam predicts NSI requirement along with warfarin use. |
• | Anticoagulants have a dynamic association with TBI outcomes. |
Plan
Vol 226 - N° 6
P. 785-789 - décembre 2023 Retour au numéro
Article précédent
- Not all traumatic brain injury patients on preinjury anticoagulation are the same
- Alicia J. Mangram
- The proteomic and metabolomic signatures of isolated and polytrauma traumatic brain injury
- Alexis L. Cralley, Chris Erickson, Terry R. Schaid, William Hallas, Otto Thielen, Sanchayita Mitra, Preston Stafford, Patrick Hom, Christopher Silliman, Mitchell J. Cohen, Ernest E. Moore, Angelo D'Alessandro, Kirk C. Hansen
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