Brain hemorrhages in traumatic brain injury and the excess burden conferred by anticoagulants and antiplatelets

Abstract

Objective: The objective of this study was to compare the severity of head injury in patients on an anticoagulant or antiplatelet agent and to look at the burden of these medications in patients 55 + years vs. younger. Methods: This was an observational cohort study of 2256 adult head trauma patients who presented to a Level I Trauma Center and were stratified by anticoagulant/antiplatelet medication use and age. Logistic regression analyses were performed to ascertain whether use of these medications resulted in worse outcomes. Results: Overall, elderly (>55yrs) patients had worse outcomes after TBI. Specifically, they were more likely to have an intracranial hemorrhage, be admitted to the hospital, have an ICU stay, be re-admitted within 30 days, die in the hospital and be dead within 3 months. Conclusion: Geriatric trauma patients along with their preexisting comorbidities are often on anticoagulants that increase their risk for complications, bleeding, mortality in the setting of even minor traumas.

Keywords

• Brain hemorrhage
• Traumatic brain injury
• Anticoagulants
• Head injury