Outcomes in Traumatic Brain Injury for Patients Presenting on Antiplatelet Therapy

Autor:	Andrew Tully, John D. Cull, Kimberly K. Nagy, Imran Sabir, Andrew Dennis, Brent L. Johnson, Henry R. Moore, Lauren M. Sakai, Faran Bokhari, Dorion Wiley, Frederic Starr, Uretz J. Oliphant, Kimberly Joseph
Rok vydání:	2015
Předmět:	medicine.medical_specialty Traumatic brain injury business.industry Case-control study Glasgow Coma Scale Poison control Subgroup analysis General Medicine Odds ratio medicine.disease Confidence interval Internal medicine medicine Injury Severity Score business
Zdroj:	The American Surgeon. 81:128-132
ISSN:	1555-9823 0003-1348
DOI:	10.1177/000313481508100223
Popis:	An increasing number of patients are presenting to trauma units with head injuries on antiplatelet therapy (APT). The influence of APTon these patients is poorly defined. This study examines the outcomes of patients on APT presenting to the hospital with blunt head trauma (BHT). Registries of two Level I trauma centers were reviewed for patients older than 40 years of age from January 2008 to December 2011 with BHT. Patients on APT were compared with control subjects. Primary outcome measures were in-hospital mortality, intracranial hemorrhage (ICH), and need for neurosurgical intervention (NI). Hospital length of stay (LOS) was a secondary outcome measure. Multivariate analysis was used and adjusted models included antiplatelet status, age, Injury Severity Score (ISS), and Glasgow coma scale (GCS). Patients meeting inclusion criteria and having complete data (n = 1547) were included in the analysis; 422 (27%) patients were taking APT. Rates of ICH, NI, and in-hospital mortality of patients with BHT in our study were 45.4, 3.1, and 5.8 per cent, respectively. Controlling for age, ISS, and GCS, there was no significant difference in ICH (odds ratio [OR], 0.84; 95% confidence interval [CI], 0.61 to 1.16), NI (OR, 1.26; 95% CI, 0.60 to 2.67), or mortality (OR, 1.79; 95% CI, 0.89 to 3.59) associated with APT. Subgroup analysis revealed that patients with ISS 20 or greater on APT had increased in-hospital mortality (OR, 2.34; 95% CI, 1.03 to 5.31). LOS greater than 14 days was more likely in the APT group than those in the non-APT group (OR, 1.85; 95% CI, 1.09 to 3.12). The effects of antiplatelet therapy in patients with BHT aged 40 years and older showed no difference in ICH, NI, and in-hospital mortality.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::9f2aa4c479f36cafb2e8401d0c1d63eb https://doi.org/10.1177/000313481508100223 Zobrazit plný text záznamu