PURPOSE: Various chemical anticoagulations are being used, not only for therapeutic but also for prophylaxis for thrombo-embolism; coumadin, aspirin, plavix and heparin are among the most common ones. The purpose of this study was to see the impact of various anti-coagulating agents in our head injury patients.
METHODS: Medical record and trauma registry was used to analyze the data of patients using anti-coagulation prior to injury. All adult trauma patients, using Aspirin (ASA), plavix, Coumadin, heparin and admitted to the hospital with Computed tomography (CT) scan evidence of brain injuries, were analyzed. Data was then compared with the control group matched with the same mechanism of injury during the same period.
RESULTS: From October 2004 through December 2006, thirty patients were admitted to the trauma center using either, antiplatelet agents or anticaogulating agent either separately or in-combination, prior to head injury. Twelve patients were using only ASA, 7 were using ASA and plavix, 5 were using coumadin, 4 were using plavix, one patient was on low molecular weight heparin and one was on coumadin and plavix. Pre-injury anticoagulated group was compared with the control group of 64 patients with CT scan evidence of head injury. There were no significant differences between the groups in terms of age (74.3 ±12.0 versus 77.9±8.0, p=0.09) sex (female 50% versus 47%), Injury Severity Score (21.4±8.7 versus 22.7±10.3, p=0.53), Glasgow Coma Scale (13.6±3.1 versus 12.2±4.4), mechanism of injury ( 100% blunt both group), total hospital days (10.4±10.3 versus 8.1±8.3, p=0.24), Intensive care unit (ICU) days (5.9±8.6 versus 4.8±7.4, p= 0.53) total blood transfusion (3.1±8.7 versus 2.5±4.9, p=0.6) and over all mortality (16.6% versus 20%).
CONCLUSION: Pre-head-injury anticoagulation did not have any significant increase in overall mortality, total hospital days, and ICU days in our patient's population.
CLINICAL IMPLICATIONS: Large clinical trials are needed to validate our data.
DISCLOSURE: Christie Bailowas, No Financial Disclosure Information; No Product/Research Disclosure Information