Effects of antiplatelet agents on outcomes for elderly patients with traumatic intracranial hemorrhage.
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.
Ohm
Christina
C
Division of Trauma Surgery and the Department of Surgery, William Beaumont Hospital, Royal Oak, Michigan 48073, USA.
Mina
Alfred
A
Howells
Greg
G
Bair
Holly
H
Bendick
Phillip
P
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
D010975:Platelet Aggregation Inhibitors