Acute complications and outcomes of acute head injury in adult patients with haemophilia.
The aim of the present study is to describe the clinical and epidemiological characteristics, complications and outcome of patients with haemophilia and acute head injury (AHI) at the emergency department (ED), and develop a protocol to prevent early and late complications. This is a retrospective cohort study including all patients with haemophilia and AHI admitted to the ED. We identified 26 patients with AHI. A computed tomography scan was carried out on all patients at admission, and again on two patients (with neurosurgical complications) 48 h later. The discharge diagnosis was as follows: 3.8% subdural haematoma, 3.8% cerebellar epidural haematoma and 92.3% uncomplicated AHI. We propose the following protocol: a computed tomography scan upon arrival and another within 48 h post-AHI, unless there is an absence of clinical symptoms. In addition, all patients must self-administer a clotting factor as soon as possible and be observed in the ED for at least 48 h.
aEmergency Department bClinical Pharmacology Department cEmergency Radiology Department dIntensive Care Unit, La Paz University Hospital, Autónoma University of Madrid, IdiPAZ, Madrid eHaematology Service, San Jorge Hospital, Huesca, Spain fEmergency Department, San Ignacio University Hospital of Bogota, Bogota, Colombia.
Maria A
MA
Rivera-Núñez
Alberto M
AM
Borobia
Jose A
JA
García-Erce
Milagros
M
Martí de Gracia
Patricia
P
Pérez-Perilla
Manuel
M
Quintana-Díaz
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D006259:Craniocerebral Trauma / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy; D004636:Emergency Service, Hospital; D020802:Epidural Abscess / Q000150:complications; D005260:Female; D006408:Hematoma, Subdural / Q000150:complications; D006467:Hemophilia A / Q000150:complications*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult