Mortality in relation to presence and type of oral antithrombotic agent among adult trauma patients: a single-center retrospective cohort study
| Autor: | Asaf Kedar, Daniel J. Weiss, Irena Hamdi-Levi, Jonathan Demma, Alon J. Pikarsky, Jonathan B. Yuval, Karry J Felix, Miklosh Bala, Ora Paltiel, Haytem Awissat, Yosef Kalish |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Blood transfusion medicine.medical_treatment Critical Care and Intensive Care Medicine law.invention Head trauma 03 medical and health sciences 0302 clinical medicine Fibrinolytic Agents law Internal medicine medicine Humans Orthopedics and Sports Medicine Retrospective Studies 030222 orthopedics Aspirin business.industry Mortality rate Warfarin Anticoagulants 030208 emergency & critical care medicine Retrospective cohort study Clopidogrel Intensive care unit Emergency Medicine Surgery business Platelet Aggregation Inhibitors medicine.drug |
| Zdroj: | European Journal of Trauma and Emergency Surgery. 48:497-505 |
| ISSN: | 1863-9941 1863-9933 |
| Popis: | Oral anticoagulants (AC) and antiplatelet (AP) agents are increasingly prescribed to prevent and treat acute and chronic thrombotic conditions. The direct oral anticoagulants (DOAC), a newer class of AC, raise concerns in the trauma setting. Our study aims to compare the mortality rates and other outcomes among adult trauma patients based on pre-admission AC/AP status. We conducted a retrospective cohort study of a prospectively collected database of trauma patients previously on DOAC, warfarin, aspirin or clopidogrel. A matched control group of trauma patients not receiving AC/AP was used for comparison. Our primary endpoint was in-hospital mortality according to antithrombotic medication class. Secondary endpoints included length of stay (LOS), intensive care unit (ICU) admission, need for blood transfusion, and discharge to a dependent setting. Univariate and multivariate analyses were conducted. There were 996 exposed patients and 234 controls, with no major clinically significant difference among study groups in terms of gender, injury site, injury severity, mechanism, and comorbidities. The mortality rates were 2.14% (control, 5/234), 2.88% (DOAC, 3/104), 3.34% (aspirin, 17/509), 7.63% (warfarin, 18/236), 9% (clopidogrel, 8/89), and 13.79% (aspirin + clopidogrel, 8/58) (p |
| Databáze: | OpenAIRE |
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