TY - JOUR
T1 - Not all traumatic brain injury patients on preinjury anticoagulation are the same
AU - BIG Multi-institutional Study Group
AU - The American Association for the Surgery of Trauma Brain Injury Guidelines Multi-institutional Study Group
AU - Bhogadi, Sai Krishna
AU - Alizai, Qaidar
AU - Colosimo, Christina
AU - Spencer, Audrey L.
AU - Stewart, Collin
AU - Nelson, Adam
AU - Ditillo, Michael
AU - Castanon, Lourdes
AU - Magnotti, Louis J.
AU - Joseph, Bellal
AU - Dultz, Linda
AU - Black, George
AU - Campbell, Marc
AU - Berndtson, Allison E.
AU - Costantini, Todd
AU - Kerwin, Andrew
AU - Skarupa, David
AU - Burruss, Sigrid
AU - Delgado, Lauren
AU - Gomez, Mario
AU - Mederos, Dalier R.
AU - Winfield, Robert
AU - Cullinane, Daniel
AU - Hosseinpour, Hamidreza
N1 - Publisher Copyright:
© 2023 Elsevier Inc.
PY - 2023/12
Y1 - 2023/12
N2 - Background: Prognostic significance of different anticoagulants in TBI patients remains unanswered. We aimed to compare effects of different anticoagulants on outcomes of TBI patients. Methods: A secondary analysis of AAST BIG MIT. Blunt TBI patients ≥50 years using anticoagulants presenting ICH were identified. Outcomes were progression of ICH and need for neurosurgical intervention (NSI). Results: 393 patients were identified. Mean age was 74 and most common anticoagulant was aspirin (30%), followed by Plavix (28%), and coumadin (20%). 20% had progression of ICH and 10% underwent NSI. On multivariate regression for ICH progression, warfarin, SDH, IPH, SAH, alcohol intoxication and neurologic exam deterioration were associated with increased odds. Warfarin, abnormal neurologic exam on presentation, and SDH were independent predictors of NSI. Conclusions: Our findings reflect a dynamic interaction between type of anticoagulants, bleeding pattern & outcomes. Future modifications of BIG may need to take the type of anticoagulant into consideration.
AB - Background: Prognostic significance of different anticoagulants in TBI patients remains unanswered. We aimed to compare effects of different anticoagulants on outcomes of TBI patients. Methods: A secondary analysis of AAST BIG MIT. Blunt TBI patients ≥50 years using anticoagulants presenting ICH were identified. Outcomes were progression of ICH and need for neurosurgical intervention (NSI). Results: 393 patients were identified. Mean age was 74 and most common anticoagulant was aspirin (30%), followed by Plavix (28%), and coumadin (20%). 20% had progression of ICH and 10% underwent NSI. On multivariate regression for ICH progression, warfarin, SDH, IPH, SAH, alcohol intoxication and neurologic exam deterioration were associated with increased odds. Warfarin, abnormal neurologic exam on presentation, and SDH were independent predictors of NSI. Conclusions: Our findings reflect a dynamic interaction between type of anticoagulants, bleeding pattern & outcomes. Future modifications of BIG may need to take the type of anticoagulant into consideration.
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U2 - 10.1016/j.amjsurg.2023.05.034
DO - 10.1016/j.amjsurg.2023.05.034
M3 - Article
C2 - 37301645
AN - SCOPUS:85163121167
SN - 0002-9610
VL - 226
SP - 785
EP - 789
JO - American journal of surgery
JF - American journal of surgery
IS - 6
ER -