Antiplatelet and anticoagulation therapies do not increase mortality in the absence of traumatic brain injury.
BACKGROUND
: As the population continues to age, the number of patients undergoing traumatic injury while on antiplatelet or anticoagulation therapies is increasing. Mortality has been shown to increase in traumatic brain injury patients on warfarin therapy. Whether this increased mortality is seen in trauma patients without traumatic brain injury remains controversial. We investigated whether patients on antiplatelet and/or anticoagulation therapy were at increased risk of death from blunt traumatic injury in the absence of head injury.


METHODS
: A retrospective review of our Level I trauma center database was performed from 2002 to 2007. Inclusion criteria included all patients older than 60 years admitted to the trauma service. Only patients with a computed tomography scan negative for intracranial injury were analyzed.


RESULTS
: Two hundred twelve patients were found, of which 67 were found to be taking aspirin, warfarin, clopidogrel, or a combination of the three. Injury Severity Score (21 vs. 21), length of stay (11 days vs. 9 days), intensive care unit days (5 days vs. 4 days), and deaths (13% vs. 10%) were similar between those patients on antiplatelet/anticoagulation therapy and those who were not.


CONCLUSIONS
: In the absence of traumatic brain injury, the use of preinjury antiplatelet and/or anticoagulation therapy does not significantly increase the risk of mortality in the trauma patient. As the number of active seniors rises, this patient population will continue to present to the trauma service. To the best of our knowledge, this study is one of the largest addressing this question, and the only study examining the addition of antiplatelet therapy.
Ott
Mickey Meilinger
MM
Grand Rapids/Michigan State University General Surgery Residency Program, Grand Rapids, Michigan, USA. meilingerott@hotmail.com
Eriksson
Evert
E
Vanderkolk
Wayne
W
Christianson
David
D
Davis
Alan
A
Scholten
Donald
D
D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D001930:Brain Injuries; D015331:Cohort Studies; D003422:Critical Care; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D015599:Trauma Severity Indices; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors