title: Effects of antiplatelet agents on outcomes for elderly patients with traumatic intracranial hemorrhage.
abstract: BACKGROUND
  Recent literature on elderly patients with traumatic intracranial hemorrhage receiving preinjury antiplatelet agents shows a mortality rate of 47%.
  
  
  METHODS
  In a retrospective analysis, patients older than 50 years presenting to the hospital over the past 4 years with traumatic intracranial hemorrhage and the use of aspirin, clopidogrel, or a combination were compared with a control group that had hemorrhage but no antiplatelet medications. Patient demographics, mechanism of injury, and injury scores were recorded.
  
  
  RESULTS
  No significant differences were found between the 90 study patients and the 89 control subjects in terms of demographics, mechanism of injury, Injury Severity Score, Glasgow Coma Score, or hospital length of stay. Patients receiving antiplatelet therapy had significantly more comorbid conditions (71% vs. 35%; p < 0.001). In this series, 21 study patients and 8 control patients died (23% vs. 8.9%; p = 0.016). Age older than 76 years and a Glasgow Coma Score lower than 12 were correlated significantly with increased mortality.
  
  
  CONCLUSIONS
  The use of antiplatelet agents with elderly trauma patients significantly increases the risk of mortality when head injury involves intracranial hemorrhage.
authors.affiliation: Division of Trauma Surgery and the Department of Surgery, William Beaumont Hospital, Royal Oak, Michigan 48073, USA.
authors.forename: Christina
authors.initials: C
authors.lastname: Ohm
authors.forename: Alfred
authors.initials: A
authors.lastname: Mina
authors.forename: Greg
authors.initials: G
authors.lastname: Howells
authors.forename: Holly
authors.initials: H
authors.lastname: Bair
authors.forename: Phillip
authors.initials: P
authors.lastname: Bendick
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000706:statistics & numerical data; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D015897:Comorbidity; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D020198:Intracranial Hemorrhage, Traumatic / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality*; D007902:Length of Stay / Q000706:statistics & numerical data; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D018579:Patient Selection; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D010976:Platelet Count; D017713:Platelet Transfusion; D011237:Predictive Value of Tests; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014754:Violence / Q000706:statistics & numerical data
chemical_list: D010975:Platelet Aggregation Inhibitors