Management Strategies and Outcomes of Hemorrhagic Traumatic Brain Injury on Oral Anticoagulants.
anticoagulation
antiplatelet
intracranial hemorrhage
traumatic brain injury
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
17 Sep 2020
17 Sep 2020
Historique:
entrez:
23
10
2020
pubmed:
24
10
2020
medline:
24
10
2020
Statut:
epublish
Résumé
Traumatic brain injury (TBI) is common, and the frequency of patients taking oral anticoagulants is increasing. However the optimal initial triage, management, and long term care plans of hemorrhagic TBI patients taking oral anticoagulants is not clear. To determine the usage pattern of reversal agents for hemorrhagic TBI patients taking oral anticoagulants, and examine their characteristics and outcomes as compared to hemorrhagic TBI patients not taking these medications. This was a single-center, retrospective, observational study. Included were adults with trauma categorization and traumatic intracranial hemorrhage (ICH) between April 1, 2017 and December 31, 2019. Patient age, type of ICH, initial Glasgow Coma Scale (GCS) score, oral anticoagulant prescribed pre-injury, anticoagulation reversal agent given, and hospital discharge disposition were recorded. For the entire sample size (n=111), the mean age and GCS were 71.6 years old and 13.8, respectively. Compared to patients not taking oral anticoagulants, patients taking oral anticoagulants were older (76.7 years old versus 69.1; This limited data set did not show improved outcomes by giving reversal agents to hemorrhagic TBI patients taking oral anticoagulants. However, until more robust data is available, judicious use of reversal agents in this high-risk patient population should remain common practice.
Identifiants
pubmed: 33094049
doi: 10.7759/cureus.10508
pmc: PMC7571597
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e10508Informations de copyright
Copyright © 2020, Krueger et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Clin Neurol Neurosurg. 2016 Jan;140:85-90
pubmed: 26688502
J Thromb Thrombolysis. 2020 Jan;49(1):121-131
pubmed: 31664662
J Thromb Haemost. 2010 Jul;8(7):1500-8
pubmed: 20403088
Neurosurgery. 2019 Apr 1;84(4):977-984
pubmed: 30101280
Cureus. 2018 Jul 3;10(7):e2920
pubmed: 30186725
Lancet. 2016 Jun 25;387(10038):2605-2613
pubmed: 27178479
Lancet. 2019 Nov 9;394(10210):1713-1723
pubmed: 31623894
Cureus. 2019 Oct 24;11(10):e5982
pubmed: 31808447
Scand J Trauma Resusc Emerg Med. 2018 Mar 27;26(1):20
pubmed: 29580268
Surgery. 2008 Oct;144(4):598-603; discussion 603-5
pubmed: 18847644
Stroke. 2015 Jul;46(7):2032-60
pubmed: 26022637
J Trauma Acute Care Surg. 2017 May;82(5):827-835
pubmed: 28431413
J Neurotrauma. 2018 Mar 1;35(5):703-718
pubmed: 29324173
J Head Trauma Rehabil. 2006 Nov-Dec;21(6):544-8
pubmed: 17122685
J Surg Res. 2019 Apr;236:224-229
pubmed: 30694760
Clin Neurol Neurosurg. 2018 Nov;174:163-166
pubmed: 30245434
CMAJ Open. 2013 Oct 16;1(3):E115-9
pubmed: 25077110