Highlights
- •The association of antithrombic agents with mortality among blunt torso trauma patients without severe traumatic brain injury remains unclear.
- •The use of pre-injury antithrombotic agents was not associated with higher mortality among patients without severe head trauma.
- •The use of pre-injury antithrombotic agents was not associated with higher rate of transfusion, surgery or increased complications.
- •Prompt intervention to prevent progressive coagulopathy and careful management are needed for patients taking antithrombotic agents.
Abstract
Aim
Patients with head trauma who take antiplatelet or anticoagulant (APAC) agents have
a higher rate of mortality. However, the association between these agents and mortality
among blunt torso trauma patients without severe traumatic brain injury remains unclear.
Methods
Using the Japanese nationwide trauma registry, we conducted a retrospective cohort
study including adult patients with blunt torso trauma without severe head trauma
between January 2019 and December 2020. Eligible patients were divided into two groups
based on whether or not they took any APAC agents. The primary outcome was in-hospital
mortality. To adjust for potential confounding factors, we conducted random effects
logistic regression to account for patients clustering within the hospitals. The model
was adjusted for potential confounders, including age, mechanism of injury, Charlson
comorbidity index, systolic blood pressure, and injury severity scale on arrival as
potentially confounding factors.
Results
During the study period, 16,201 patients were eligible for the analysis. A total of
832 patients (5.1%) were taking antiplatelet or anticoagulant agents. Overall in-hospital
mortality was 774 patients (4.8%). APAC group had a higher risk of in-hospital mortality
compared with the non-APAC group (6.9% vs. 4.7%; unadjusted OR, 1.51; 95% CI, 1.12–2.00;
P < 0.01). After adjusting for potential confounder, there were no significant intergroup
difference in a higher in-hospital mortality compared to with the non-APAC group (OR,
1.07; 95%CI, 0.65–1.77; P = 0.79).
Conclusion
The use of APAC agents before the injury was not associated with higher in-hospital
mortality among blunt torso trauma patients without severe traumatic brain injury.
Key words
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Article info
Publication history
Published online: July 28, 2022
Accepted:
July 26,
2022
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
