Anticoagulation is Associated with Increased Mortality in Splenic Injuries
| Autor: | Robert D. Becher, Kevin M. Schuster, Bishwajit Bhattacharya, Kimberly A. Davis, Adrian A. Maung |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Demographics Hemorrhage Abdominal Injuries Young Adult 03 medical and health sciences Injury Severity Score 0302 clinical medicine Risk Factors Internal medicine medicine Humans In patient Aged Retrospective Studies Aged 80 and over business.industry Anticoagulants Middle Aged Logistic Models 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology Surgery business Spleen |
| Zdroj: | Journal of Surgical Research. 266:1-5 |
| ISSN: | 0022-4804 |
| Popis: | Anticoagulation (AC) is associated with worse outcomes after trauma in some but not all studies. To further investigate the effect of AC on outcomes in patients with splenic injury, we analyzed the Trauma Quality Programs Participant Use File (PUF) METHODS: The 2017 PUF was used to identify adult (18+ y) with all mechanisms and grades of splenic injury. Demographics, comorbidities, hospital course and outcomes were compared between AC and non-AC patients.A total of 18,749 patients were included, 622 were on AC. The AC patients were older but had comparable gender composition to non-AC patients. Injury Severity Score (18.2 versus 22.5) and rates of serious (AIS ≥ 3) injury were all lower in the AC group (P = 0.001). AC patients received fewer units of RBC (5.7 versus 8.0 units, P0.001) and FFP (3.9 versus 5.4 units, P0.001) in the first 24 h but underwent angiography at similar rates (23.6 versus 24.5%, P = 0.8). Among those who underwent angiography, patients were more likely to undergo embolization if they were on AC (89.7 versus 73.9%, P = 0.04). Rates of splenic surgery were comparable (19.3 versus 21.5%, P = 0.2) between AC versus non-AC patients. Median LOS was longer in AC patients (6.3 versus 5.6 d, P = 0.002). AC patients had a higher mortality (13.3 versus 7.0%, P = 0.001). In a multivariable binary logistic regression, AC was an independent risk factor for mortality with OR 1.4 (95% CI: 1.1-1.9) CONCLUSIONS: Anticoagulation is associated with increased mortality in patients with splenic injury. |
| Databáze: | OpenAIRE |
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