PMID- 35843581
OWN - NLM
STAT- MEDLINE
DCOM- 20221005
LR  - 20221214
IS  - 1878-8769 (Electronic)
IS  - 1878-8750 (Linking)
VI  - 166
DP  - 2022 Oct
TI  - The Impact of Preinjury Antiplatelet and Anticoagulant Use on Elderly Patients 
      with Moderate or Severe Traumatic Brain Injury Following Traumatic Acute Subdural 
      Hematoma.
PG  - e521-e527
LID - S1878-8750(22)00990-1 [pii]
LID - 10.1016/j.wneu.2022.07.042 [doi]
AB  - BACKGROUND: Although it is often assumed that preinjury anticoagulant (AC) or 
      antiplatelet (AP) use is associated with poorer outcomes among those with acute 
      subdural hematoma (aSDH), previous studies have had varied results. This study 
      examines the impact of preinjury AC and AP therapy on aSDH thickness, 30-day 
      mortality, and extended Glasgow Outcome Scale at 6 months in elderly patients 
      (aged >/=65). METHODS: A level 1 trauma center registry was interrogated to 
      identify consecutive elderly patients who presented with moderate or severe 
      traumatic brain injury (TBI) and associated traumatic aSDH between the first of 
      January 2013 and the first of January 2018. Relevant demographic, clinical, and 
      radiological data were retrieved from institutional medical records. The 3 
      primary outcome measures were aSDH thickness on initial computed tomography scan, 
      30-day mortality, and unfavorable outcome at 6 months (extended Glasgow Outcome 
      Scale). RESULTS: One hundred thirty-two elderly patients were admitted with 
      moderate or severe TBI and traumatic aSDH. The mean (+/-SD) age was 78.39 (+/-7.87) 
      years, and a majority of patients (59.8%, n = 79) were male. There was a 
      statistically significant difference in mean aSDH thickness, but there were no 
      significant differences in 30-day mortality (P = 0.732) and unfavorable outcome 
      between the AP, AC, combined AP and AC, and no antithrombotic exposure groups 
      (P = 0.342). CONCLUSIONS: Further studies with larger sample sizes are necessary 
      to confirm these observations, but our findings do not support the preconceived 
      notion in clinical practice that antithrombotic use is associated with poor 
      outcomes in elderly patients with moderate or severe TBI.
CI  - Copyright (c) 2022 Elsevier Inc. All rights reserved.
FAU - O'Donohoe, Rory B
AU  - O'Donohoe RB
AD  - National Trauma Research Institute (NTRI), Melbourne, Australia; The University 
      of Notre Dame, School of Medicine, Sydney, Australia. Electronic address: 
      rbodonohoe@gmail.com.
FAU - Lee, Hui Qing
AU  - Lee HQ
AD  - National Trauma Research Institute (NTRI), Melbourne, Australia; Department of 
      Neurosurgery, Alfred Health, Melbourne, Australia.
FAU - Tan, Terence
AU  - Tan T
AD  - National Trauma Research Institute (NTRI), Melbourne, Australia.
FAU - Hendel, Simon
AU  - Hendel S
AD  - National Trauma Research Institute (NTRI), Melbourne, Australia; Trauma Service, 
      Alfred Health, Melbourne, Australia; Department of Anaesthesia and Perioperative 
      Medicine, Central Clinical School, Monash University, Melbourne, Australia.
FAU - Hunn, Martin
AU  - Hunn M
AD  - National Trauma Research Institute (NTRI), Melbourne, Australia; Department of 
      Neurosurgery, Alfred Health, Melbourne, Australia; Department of Surgery, Central 
      Clinical School, Monash University, Melbourne, Australia.
FAU - Mathews, Joseph
AU  - Mathews J
AD  - National Trauma Research Institute (NTRI), Melbourne, Australia; Trauma Service, 
      Alfred Health, Melbourne, Australia; Emergency & Trauma Centre, The Alfred 
      Hospital, Melbourne, Australia.
FAU - Fitzgerald, Mark
AU  - Fitzgerald M
AD  - National Trauma Research Institute (NTRI), Melbourne, Australia; Trauma Service, 
      Alfred Health, Melbourne, Australia; Emergency & Trauma Centre, The Alfred 
      Hospital, Melbourne, Australia.
FAU - Rosenfeld, Jeffrey V
AU  - Rosenfeld JV
AD  - National Trauma Research Institute (NTRI), Melbourne, Australia; Department of 
      Neurosurgery, Alfred Health, Melbourne, Australia.
FAU - Tee, Jin
AU  - Tee J
AD  - National Trauma Research Institute (NTRI), Melbourne, Australia; Department of 
      Neurosurgery, Alfred Health, Melbourne, Australia.
LA  - eng
PT  - Journal Article
DEP - 20220714
PL  - United States
TA  - World Neurosurg
JT  - World neurosurgery
JID - 101528275
RN  - 0 (Anticoagulants)
SB  - IM
MH  - Aged
MH  - Anticoagulants/adverse effects
MH  - *Brain Injuries, Traumatic/complications/diagnostic imaging/drug therapy
MH  - Female
MH  - Glasgow Outcome Scale
MH  - Hematoma, Subdural/complications
MH  - *Hematoma, Subdural, Acute/complications
MH  - *Hematoma, Subdural, Intracranial/complications
MH  - Humans
MH  - Male
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Acute subdural hematoma
OT  - Anticoagulant
OT  - Antiplatelet
OT  - Moderate and severe traumatic brain injury (TBI)
EDAT- 2022/07/18 06:00
MHDA- 2022/10/06 06:00
CRDT- 2022/07/17 19:29
PHST- 2022/05/01 00:00 [received]
PHST- 2022/07/09 00:00 [revised]
PHST- 2022/07/09 00:00 [accepted]
PHST- 2022/07/18 06:00 [pubmed]
PHST- 2022/10/06 06:00 [medline]
PHST- 2022/07/17 19:29 [entrez]
AID - S1878-8750(22)00990-1 [pii]
AID - 10.1016/j.wneu.2022.07.042 [doi]
PST - ppublish
SO  - World Neurosurg. 2022 Oct;166:e521-e527. doi: 10.1016/j.wneu.2022.07.042. Epub 
      2022 Jul 14.