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The Impact of Preinjury Antiplatelet and Anticoagulant Use on Elderly Patients with Moderate or Severe Traumatic Brain Injury Following Traumatic Acute Subdural Hematoma.
O'Donohoe, Rory B; Lee, Hui Qing; Tan, Terence; Hendel, Simon; Hunn, Martin; Mathews, Joseph; Fitzgerald, Mark; Rosenfeld, Jeffrey V; Tee, Jin.
Afiliación
  • O'Donohoe RB; National Trauma Research Institute (NTRI), Melbourne, Australia; The University of Notre Dame, School of Medicine, Sydney, Australia. Electronic address: rbodonohoe@gmail.com.
  • Lee HQ; National Trauma Research Institute (NTRI), Melbourne, Australia; Department of Neurosurgery, Alfred Health, Melbourne, Australia.
  • Tan T; National Trauma Research Institute (NTRI), Melbourne, Australia.
  • Hendel S; National Trauma Research Institute (NTRI), Melbourne, Australia; Trauma Service, Alfred Health, Melbourne, Australia; Department of Anaesthesia and Perioperative Medicine, Central Clinical School, Monash University, Melbourne, Australia.
  • Hunn M; National Trauma Research Institute (NTRI), Melbourne, Australia; Department of Neurosurgery, Alfred Health, Melbourne, Australia; Department of Surgery, Central Clinical School, Monash University, Melbourne, Australia.
  • Mathews J; National Trauma Research Institute (NTRI), Melbourne, Australia; Trauma Service, Alfred Health, Melbourne, Australia; Emergency & Trauma Centre, The Alfred Hospital, Melbourne, Australia.
  • Fitzgerald M; National Trauma Research Institute (NTRI), Melbourne, Australia; Trauma Service, Alfred Health, Melbourne, Australia; Emergency & Trauma Centre, The Alfred Hospital, Melbourne, Australia.
  • Rosenfeld JV; National Trauma Research Institute (NTRI), Melbourne, Australia; Department of Neurosurgery, Alfred Health, Melbourne, Australia.
  • Tee J; National Trauma Research Institute (NTRI), Melbourne, Australia; Department of Neurosurgery, Alfred Health, Melbourne, Australia.
World Neurosurg ; 166: e521-e527, 2022 10.
Article en En | MEDLINE | ID: mdl-35843581
BACKGROUND: Although it is often assumed that preinjury anticoagulant (AC) or antiplatelet (AP) use is associated with poorer outcomes among those with acute subdural hematoma (aSDH), previous studies have had varied results. This study examines the impact of preinjury AC and AP therapy on aSDH thickness, 30-day mortality, and extended Glasgow Outcome Scale at 6 months in elderly patients (aged ≥65). METHODS: A level 1 trauma center registry was interrogated to identify consecutive elderly patients who presented with moderate or severe traumatic brain injury (TBI) and associated traumatic aSDH between the first of January 2013 and the first of January 2018. Relevant demographic, clinical, and radiological data were retrieved from institutional medical records. The 3 primary outcome measures were aSDH thickness on initial computed tomography scan, 30-day mortality, and unfavorable outcome at 6 months (extended Glasgow Outcome Scale). RESULTS: One hundred thirty-two elderly patients were admitted with moderate or severe TBI and traumatic aSDH. The mean (±SD) age was 78.39 (±7.87) years, and a majority of patients (59.8%, n = 79) were male. There was a statistically significant difference in mean aSDH thickness, but there were no significant differences in 30-day mortality (P = 0.732) and unfavorable outcome between the AP, AC, combined AP and AC, and no antithrombotic exposure groups (P = 0.342). CONCLUSIONS: Further studies with larger sample sizes are necessary to confirm these observations, but our findings do not support the preconceived notion in clinical practice that antithrombotic use is associated with poor outcomes in elderly patients with moderate or severe TBI.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hematoma Subdural Agudo / Hematoma Intracraneal Subdural / Lesiones Traumáticas del Encéfalo Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male Idioma: En Revista: World Neurosurg Asunto de la revista: NEUROCIRURGIA Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hematoma Subdural Agudo / Hematoma Intracraneal Subdural / Lesiones Traumáticas del Encéfalo Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male Idioma: En Revista: World Neurosurg Asunto de la revista: NEUROCIRURGIA Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos