Central Surgical AssociationImpact of preinjury warfarin and antiplatelet agents on outcomes of trauma patients
Section snippets
Methods
After approval by an institutional review board, data were obtained retrospectively from the trauma registry at a New York State level 1 trauma center over a 40-month period from September 2004 to December 2007. Eligible patients consisted of all trauma patients who met inclusion criteria of the New York State Trauma Registry. Patients were divided into groups: patients taking only warfarin or clopidogrel or aspirin or various combinations of these drugs or compared to a control group of
Patient demographics and study variables
For the 40-month period, 3,436 patients were identified in the trauma registry. Patient demographics and distribution of the study variables associated significantly with the risk of mortality on bivariate analysis are presented in Table I; this Table also lists the distribution of patients who took various combinations of the WAA medications before injury. Overall, greater than 50% patients had an ISS >15. Nearly 70% of patient with ICH had an ISS >15.
Of the 3,436 patients in this study, 456
Discussion
This study supports other studies reporting that preinjury use of medications that alter bleeding time and coagulation were associated with a greater overall mortality and a greater rate of traumatic brain injury. All-cause mortality was associated independently with warfarin use but not with the use of aspirin or clopidogrel. Lack of differences in ICU stay and hospital LOS may be because of some early deaths in the WAA group. Increased early deaths in the WAA group also could explain why
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