PMID- 30064584
OWN - NLM
STAT- MEDLINE
DCOM- 20180822
LR  - 20180822
IS  - 1555-9823 (Electronic)
IS  - 0003-1348 (Linking)
VI  - 84
IP  - 7
DP  - 2018 Jul 1
TI  - Does Antithrombotic Drug Use Mandate Trauma Team Activation in Awake Geriatric 
      Patients with Intracranial Hemorrhage?
PG  - 1180-1184
AB  - Antithrombotic (anticoagulant [AC] and antiplatelet [AP]) drugs have been 
      associated with mortality in geriatric patients with intracranial hemorrhage 
      (ICH). It is unclear whether trauma team activation (TTA) in this cohort impacts 
      outcome. Patients >/=65 years with a Glasgow Coma Scale of >/=13 and ICH over four 
      years were included and were divided into three groups according to type of drug: 
      group 1, AC with or without AP; group 2, AP only and; group 3, no AC or AP. The 
      Rotterdam score was used to characterize the severity of CT findings. The primary 
      outcome was inhospital mortality or transition to comfort measures. The secondary 
      outcome was need for neurosurgical intervention within 48 hours. Logistic 
      regression analysis was performed to evaluate for predictors of each outcome. Of 
      419 patients, 20.5, 50.4, and 29.1 per cent belonged to groups 1, 2, and 3, 
      respectively, with TTA occurring in 39.5, 18.0, and 32.0 per cent of the 
      respective groups. Within each group, there were no differences for the primary 
      and secondary outcomes whether or not TTA was triggered. TTA patients had shorter 
      times to CT (median, 20 minutes versus 80 minutes, P < 0.0001) and to 
      administration of reversal agents (median, 105 minutes versus 255 minutes, P < 
      0.0001). Age, head-Abbreviated Injury Score, and the Rotterdam score were 
      predictors for both outcomes by multivariable analysis, whereas antithrombotic 
      drug use and TTA were not. In awake elderly patients on antithrombotic drugs 
      found to have ICH, TTA expedited evaluation and treatment but was not associated 
      with mortality benefit.
FAU - Moyer, Jeffrey A
AU  - Moyer JA
FAU - Shah, Jharna
AU  - Shah J
FAU - Nowakowski, Kevin
AU  - Nowakowski K
FAU - Martin, Anthony
AU  - Martin A
FAU - McNicholas, Amanda
AU  - McNicholas A
FAU - Muller, Alison
AU  - Muller A
FAU - Fernandez, Forrest B
AU  - Fernandez FB
FAU - Ong, Adrian W
AU  - Ong AW
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Am Surg
JT  - The American surgeon
JID - 0370522
RN  - 0 (Anticoagulants)
RN  - 0 (Platelet Aggregation Inhibitors)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - *Aging
MH  - Anticoagulants/administration & dosage/*adverse effects
MH  - Brain Injuries/complications/diagnosis/*drug therapy/mortality
MH  - Drug Therapy, Combination
MH  - *Emergency Service, Hospital
MH  - Female
MH  - *Geriatrics
MH  - Glasgow Coma Scale
MH  - Hospital Mortality
MH  - Humans
MH  - Intracranial Hemorrhages/diagnosis/*drug therapy/etiology/mortality
MH  - Male
MH  - Platelet Aggregation Inhibitors/*administration & dosage
MH  - Retrospective Studies
MH  - Severity of Illness Index
MH  - Treatment Outcome
EDAT- 2018/08/02 06:00
MHDA- 2018/08/23 06:00
CRDT- 2018/08/02 06:00
PHST- 2018/08/02 06:00 [entrez]
PHST- 2018/08/02 06:00 [pubmed]
PHST- 2018/08/23 06:00 [medline]
PST - ppublish
SO  - Am Surg. 2018 Jul 1;84(7):1180-1184.