title: Low-dose aspirin therapy is not a reason for repeating head computed tomographic scans in traumatic brain injury: a prospective study.
abstract: BACKGROUND
  Most studies have categorized all antiplatelet drugs into one category. The aim of our study was to evaluate the utility of repeat head computed tomography (RHCT) and outcomes in patients on low-dose aspirin (acetylsalicylic acid; ASA) therapy.
  
  
  METHODS
  Patients with traumatic brain injury with intracranial hemorrhage on initial head computed tomography (CT) were prospectively enrolled. Patients on prehospital low-dose (81 mg) aspirin therapy were matched with patients exclusive of antiplatelet and anticoagulation therapy using propensity score matching in a 1:1 ratio for age, Glasgow Coma Scale, head Abbreviated Injury Scale score, Injury Severity Score, and neurological examination. Outcome measures were progression on RHCT and subsequent neurosurgical intervention.
  
  
  RESULTS
  A total of 144 patients who had intracranial hemorrhage on initial CT scan (ASA group: 72; No-ASA group: 72) were enrolled. The mean age was 72.8 ± 11.7 years, 59.7% were male, and median head Abbreviated Injury Scale was 3 (2-3). There was no difference in progression on RHCT (25% in ASA versus 16.6% in no-ASA), change in management as a result of RHCT (1.4% versus 1.4%), RHCT as a result of neurological decline (0 versus 1.4%), discharge Glasgow Coma Scale (15 [14-15] versus 15 [14-15]), and mortality (0 versus 1.4%) between the two groups.
  
  
  CONCLUSIONS
  Low-dose aspirin therapy is not associated with progression of initial insult on RHCT or clinical deterioration. Prehospital low-dose aspirin therapy as a sole criterion should not warrant a routine repeat head CT in traumatic brain injury.
authors.affiliation: Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, Arizona. Electronic address: bjoseph@surgery.arizona.edu.
authors.forename: Bellal
authors.initials: B
authors.lastname: Joseph
authors.forename: Hassan
authors.initials: H
authors.lastname: Aziz
authors.forename: Viraj
authors.initials: V
authors.lastname: Pandit
authors.forename: Narong
authors.initials: N
authors.lastname: Kulvatunyou
authors.forename: Terence
authors.initials: T
authors.lastname: O'Keeffe
authors.forename: Andrew
authors.initials: A
authors.lastname: Tang
authors.forename: Julie
authors.initials: J
authors.lastname: Wynne
authors.forename: Ammar
authors.initials: A
authors.lastname: Hashmi
authors.forename: Gary
authors.initials: G
authors.lastname: Vercruysse
authors.forename: Randall S
authors.initials: RS
authors.lastname: Friese
authors.forename: Peter
authors.initials: P
authors.lastname: Rhee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000009:adverse effects*; D001930:Brain Injuries / Q000000981:diagnostic imaging*; D005260:Female; D006257:Head / Q000000981:diagnostic imaging*; D006801:Humans; D020300:Intracranial Hemorrhages / Q000139:chemically induced / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D010975:Platelet Aggregation Inhibitors; D001241:Aspirin