title: Intracranial complications after minor head injury (MHI) in patients taking vitamin K antagonists (VKA) or direct oral anticoagulants (DOACs).
abstract: BACKGROUND
  The correlation between chronic direct oral anticoagulants (DOACs) intake and the incidence of intracranial complications after minor head injury (MHI) is still not well defined. This study examined the incidence of complications in patients receiving vitamin K antagonists (VKA) or DOACs observed in the emergency department (ED) for MHI.
  
  
  METHODS
  Two hundred twenty-five patients affected by MHI and receiving oral anticoagulants were recorded between January and December 2016, distinguishing those treated with VKA (118) from those receiving DOACs (107). All patients underwent a CT scan and were observed for 24h in the ED. Follow-up was performed up to 1month after the head trauma.
  
  
  RESULTS
  The rate of intracranial hemorrhage was significantly lower in patients treated with DOACs than in patients treated with VKA. We recorded 2 deaths among the 12 patients who experienced intracranial complications in the VKA group.
  
  
  CONCLUSIONS
  DOACs seem to have a more favorable safety profile than VKA in patients affected by MHI. This observation is important in light of the increasing number of elderly patients who are receiving anticoagulant therapy.
authors.affiliation: S.C. Medicina e Chirurgia d'Accettazione e d'Urgenza, Ospedale San Paolo, Savona - ASL N°2 Savonese, Italy. Electronic address: dottriccardi@gmail.com.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Riccardi
authors.affiliation: S.C. Medicina e Chirurgia d'Accettazione e d'Urgenza, Ospedale San Paolo, Savona - ASL N°2 Savonese, Italy.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Spinola
authors.affiliation: S.C. Medicina e Chirurgia d'Accettazione e d'Urgenza, Ospedale San Paolo, Savona - ASL N°2 Savonese, Italy.
authors.forename: Pierangela
authors.initials: P
authors.lastname: Minuto
authors.affiliation: S.C. Medicina e Chirurgia d'Accettazione e d'Urgenza, Ospedale San Paolo, Savona - ASL N°2 Savonese, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Ghinatti
authors.affiliation: S.C. Medicina e Chirurgia d'Accettazione e d'Urgenza, Ospedale San Paolo, Savona - ASL N°2 Savonese, Italy.
authors.forename: Grazia
authors.initials: G
authors.lastname: Guiddo
authors.affiliation: S.C. Medicina e Chirurgia d'Accettazione e d'Urgenza, Ospedale San Paolo, Savona - ASL N°2 Savonese, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Malerba
authors.affiliation: S.C. Medicina e Chirurgia d'Accettazione e d'Urgenza, Ospedale San Paolo, Savona - ASL N°2 Savonese, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Lerza
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D006259:Craniocerebral Trauma / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D020198:Intracranial Hemorrhage, Traumatic / Q000453:epidemiology*; D007558:Italy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D054556:Venous Thromboembolism / Q000517:prevention & control; D014812:Vitamin K / Q000008:administration & dosage*
chemical_list: D000925:Anticoagulants; D014812:Vitamin K
keywords: Direct oral anticoagulants; Minor head injury; Vitamin K antagonists